• Local or regional anesthesia for surgery.
• Acute pain management.

Contraindicated in:

• Hypersensitivity; cross-sensitivity with other amide local anesthetics may occur (bupivacaine, lidocaine, mepivacaine, prilocaine).

Use Cautiously in:

• Concurrent use of other local anesthetics
• Liver disease
• Concurrent use of anticoagulants (including low-dose heparin and low-molecular-weight heparins/heparinoids) ↑ the risk of spinal/epidural hematomas
• Pedi: Safety not established.

CNS: SEIZURES, anxiety, dizziness, headache, rigors.

CV: CARDIOVASCULAR COLLAPSE, arrhythmias, bradycardia, chest pain, hypertension, hypotension, tachycardia.

GI: nausea, vomiting.

GU: urinary retention.

Derm: pruritus.

F and E: hypokalemia, metabolic acidosis.

Hemat: anemia.

Neuro: circumoral tingling/numbness, paresthesia.

Resp: dyspnea.

MS: chondrolysis.
Misc: allergic reactions, fever.

Drug-Drug:

• Additive toxicity may occur with concurrent use of other amide local anesthetics (includinglidocaine, mepivacaine, and prilocaine).
• Fluvoxamine, amiodarone, ciprofloxacin, and propofol may ↑ the effects of ropivacaine.

(Generic available)

• Solution for injection (preservative-free): 0.2%; 0.5%; 0.75%; 1%;
• Premixed infusion: 2 mg/mL (0.2%); 5 mg/mL (0.5%);

Surgical Anesthesia

• Epidural (Adults): Lumbar epidural — 15–30 mL of 0.5% solution or 15–25 mL of 0.75% solution or 15–20 mL of 1% solution; Lumbar epidural for cesarean section — 20–30 mL of 0.5% solution or 15–20 mL of 0.75% solution; Thoracic epidural — 5–15 mL of 0.5–0.75% solution.
• Major nerve block (Adults): 35–50 mL of 0.5% solution or 10–40 mL of 0.75% solution.
• Field block (Adults): 1–40 mL of 0.5% solution.

Labor Pain

• Epidural (Adults): Lumbar epidural — 10–20 mL of 0.2% solution initially, then continuous infusion of 6–14 mL/hr of 0.2% solution with incremental injection of 10–15 mL/hr of 0.2% solution.

Postoperative Pain

• Epidural (Adults): Lumbar or thoracic epidural — Continuous infusion of 6–14 mL/hr of 0.2% solution.
• Infiltration (minor nerve block) (Adults): 1–100 mL of 0.2% solution or 1–40 mL of 0.5% solution.

Naropin

• Local anesthetics inhibit initiation and conduction of sensory nerve impulses by altering the influx of sodium and efflux of potassium in neurons, slowing or stopping pain transmission.

• Decreased pain or induction of anesthesia; low doses have minimal effect on sensory or motor function; higher doses may produce complete motor blockade.

Therapeutic Classification: epidural local anesthetics, anesthetics (topical/local)

Absorption: Systemic absorption follows epidural administration, but amount absorbed depends on dose.

Distribution: If systemic absorption occurs, this agent is widely distributed and crosses the placenta.

Metabolism/Excretion: Small amounts that may reach systemic circulation are mostly metabolized by the liver; <1% excreted unchanged in the urine.

Half-life: 4.2 hr (after epidural use).

(analgesia)

†Duration of anesthetic block.

• Instruct patient to notify nurse if signs or symptoms of systemic toxicity occur.
• Advise patient to request assistance during ambulation until orthostatic hypotension and motor deficits are ruled out.

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