Ropivacaine (Injection)

Ropivacaine induces local anesthesia and provides pain relief, as well as numbness to patients who are due to undergo surgery or who are in labor.

Overview

Normally administered as an injection, Ropivacaine is used to create a loss of feeling or numbness in a particular area of the body. Unlike general anesthetics, Ropivacaine does not cause the patient to lose consciousness. Instead, it causes a loss of feeling in the affected area. This means that surgical procedures can be carried out on the patient without them feeling any pain or discomfort and without the patient being unconscious.

Ropivacaine works by blocking the patient's nerve impulses. It's these impulses which would normally send pain signals to the brain. By temporarily blocking them, Ropivacaine enables physicians to carry out potentially uncomfortable procedures without the patient feeling anything at all.

As Ropivacaine can be administered to relatively small areas, it can be used to induce an epidural or spinal block. Often given to women during labor and delivery, Ropivacaine can be administered prior to a natural labor or a cesarean section.

In addition to this, Ropivacaine may be given to patients before local surgeries, oral procedures and for diagnostic purposes. As local anesthetics tend to wear off more quickly than a general anesthetic, patients should have a quicker recovery time when Ropivacaine is used, as opposed to drugs used to induce a complete loss of consciousness.

Furthermore, if it is vital for the patient to remain awake during a surgical procedure, Ropivacaine can be used to facilitate this. Similarly, patients who are not suitable candidates for general anesthetic may be given a local anesthetic, such as Ropivacaine, so that surgical procedures can be carried out upon them.

As well as being used on patients of various ages and genders prior to surgical procedures, Ropivacaine is given to numerous women during labor. As Ropivacaine is fast-acting, it can be used when urgent treatment is necessary, such as an emergency cesarean section and it can also be used if women request pain-relieving medications during labor.

Conditions Treated

  • Used to minimize pain during surgeries and/or labor

Type of Medicine

  • Local Anesthetic

Side Effects

Although side effects can occur when any medication is taken, there are relatively few side effects associated with the use of Ropivacaine. In rare cases, patients may experience:

  • Pain
  • Prickling or burning sensation
  • Itching
  • Fever
  • Back pain
  • Difficulty urinating

As Ropivacaine is only administered in a medical or clinical setting, it should be easy for patients to access medical help if they begin to experience side-effects. If patients notice any adverse effects after the Ropivacaine has been administered, they should inform their medical team immediately. This will enable their doctor to assess the side effects and confirm that the Ropivacaine is not having any harmful effects on the patient.

Dosage

Before administering the medication, doctors will determine what the appropriate dose of Ropivacaine is. They will take into the account the patient's age, medical history and the reason Ropivacaine is being administered. Physicians will also consider whether any other medications are being used in conjunction with Ropivacaine before determining what dose should be given to the patient.

Although various forms of Ropivacaine are available, it is often used at a strength of 2mg Ropivacaine per milliliter of solution. When a 10ml vial of Ropivacaine is used, this equates to 20mg Ropivacaine, while a 20ml vial at the same strength delivers 40mg of Ropivacaine.

When giving Ropivacaine to patients to reduce labor pains, physicians typically administer a dose 20-40mg, depending on the patient's needs. Following this, intermittent injections can be administered, if the patient's condition requires it. Normally, top up doses of Ropivacaine are limited to a maximum of 20-30mg per hour when the medication is being used to combat labor pains.

If Ropivacaine is given for a cesarean section, however, a standard dose of 150mg-200mg is normally administered. As this dose should normally last approximately two to four hours, top up injections are not usually required or recommended.

Alternatively, if Ropivacaine is administered to induce postoperative analgesia via a lumbar epidural, physicians may give patients a dose of 75-300mg, while top-up injections can vary from 12-28mg per hour. If a thoracic epidural is used as the delivery method, however, physicians may prescribe 25-75mg of Ropivacaine, with 12-28mg administered via top up injections, if needed.

When giving Ropivacaine, physicians will typically use the lowest dose possible, whilst still achieving the appropriate level of pain relief and numbness. If the patient's condition requires it, a maximum dose of 770mg over a 24 hour period may be given.

When physicians need to induce a minor nerve block, 5-200mg of Ropivacaine should be sufficient to achieve numbness in the affected area. For nerve blocks covering a larger area, however, a dose of 175-250mg may be given.

If Ropivacaine is prescribed for children, the appropriate dose will depend on the patient's weight and the method of delivery. If administered via a caudal block, for example, children between the ages of two and eight will often be given 2mg of Ropivacaine per kg of body weight. Alternatively, Ropivacaine delivered via an alternative epidural block will be given at a rate of 1.7mg per kg of body weight. Finally, pediatric patients can be given Ropivacaine via an epidural continuous infusion with a loading dose of 1mg per kg of body weight, followed by 0.4mg per kg of bodyweight per hour.

When administering Ropivacaine, it's vital that physicians choose the right method of delivery. This ensures that patients will get the full benefit of the drug and that their dose is not unnecessarily high.

As patients are given Ropivacaine via injection or infusion, their treatment will be administered by a trained medical professional.

Interactions

If patients are taking other medications or have taken other medicines recently, it may affect the use of Ropivacaine. Patients are not usually given Ropivacaine if they are also taking:

  • St. John's Wort
  • Hyaluronidase
  • Pixantrone
  • Peginterferon Alfa-2b

Although the above medications are not usually recommended alongside Ropivacaine, physicians may be able to prevent drug interactions from occurring by modifying the patient's dose.

If Ropivacaine is given alongside the following medications, it could increase the chance of side-effects occurring:

  • Fluvoxamine
  • Ciprofloxacin

Although Ropivacaine may be given in conjunction with the drugs listed above, patients may require an altered dose in order to avoid side-effects or they may require additional medications in order to reduce any side-effects which do occur.

Using Ropivacaine whilst smoking or chewing tobacco can also cause interactions to occur. If patients regularly smoke or use tobacco, they should inform their doctor before receiving any treatment.

Warnings

If patients have been diagnosed with any of the following conditions, it may affect their treatment with Ropivacaine:

In some instances, Ropivacaine can make the symptoms of heart disease worse so patients with this condition may need to be treated with an alternative medication.

As liver and/or kidney disease can make it more difficult for patients to process medications, they may suffer from an increased number of side-effects whilst being treated with Ropivacaine. If their existing health condition prevents them from metabolizing Ropivacaine at a standard dose, a lower dose may be given. However, patients will only benefit from a lower dose of Ropivacaine if it still achieves the appropriate level of pain relief and numbness.

Currently, Ropivacaine is not thought to present a significant risk to pregnant patients or an unborn fetus. Due to this, Ropivacaine is often used to treat women who are pregnant or who are in labor. However, if patients are pregnant and are receiving treatment with Ropivacaine for non-labor related reasons, they should inform their doctor.

It is not yet known whether Ropivacaine can be passed to an infant via breastfeeding and, if so, whether it could cause harm to the child. Due to this, patients should discuss the potential risks with their physician before breastfeeding, if they have been treated with Ropivacaine.

As Ropivacaine has a numbing effect, patients can sustain injuries to the affected area without realizing it. Patients will need to be particularly careful until the numbness has worn off.

If patients exhibit an allergic reaction to Ropivacaine, it should be treated as a medical emergency. As Ropivacaine is typically administered by healthcare professionals in a clinical setting, they should monitor the patient regularly and respond to any allergic reactions as required.

Storage

Once Ropivacaine has been opened, it should be used immediately. As the medication is normally stored in single-use containers, it can be stored without being opened until it is needed. Ropivacaine is usually stored a room temperature and should not typically be frozen.

As the medicine is administered by medical professionals, patients will not need to administer or store Ropivacaine themselves.

Summary

If patients are due to undergo a surgical procedure or have recently had surgery, Ropivacaine can be used to provide a local anesthetic. Although the drug ensures complete numbness in the affected areas, it does not result in the patient losing consciousness. This is particularly beneficial for women in labor as they maintain consciousness throughout the delivery process.

Due to its fast-acting nature, Ropivacaine can deliver pain relief and numbness within a matter of minutes. Whether patients are scheduled to receive the medicine or require pain relieving medicine in response to a medical emergency, Ropivacaine can be used with high levels of efficacy.

 

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Last Reviewed:
January 30, 2018
Last Updated:
April 05, 2018
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