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Local Anesthetic

Ropivacaine

Long-acting amide LA (S-enantiomer) · Naropin

Mechanism: Na+ channel blockade; preferential sensory > motor block.

Onset
10–20 min
Duration
3–6 h
Metabolism
Hepatic CYP1A2.

Dosing

Adult
Max: 3 mg/kg. Epidural 0.1–0.2% infusion 6–14 mL/h.

Indications

  • Peripheral nerve blocks
  • Epidural labor analgesia

Contraindications

  • IV regional

Side Effects

  • LAST (less cardiotoxic than bupivacaine)

Clinical Pearls

1Excellent labor epidural agent — analgesia with preserved motor function.

References & Further Reading

  1. 1
    Textbook

    Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.

  2. 2
    GuidelineOpen source

    Neal JM, Neal EJ, Weinberg GL. American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity Checklist: 2020 Version. Reg Anesth Pain Med. 2021;46(1):81-82.

  3. 3
    Textbook

    Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.

  4. 4
    Textbook

    Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.