Ropivacain

Ropivacain, also spelled ropivacain in some regions, refers to the local anesthetic ropivacaine. It is a long-acting amide-type local anesthetic used to provide regional anesthesia and analgesia. Ropivacaine is the pure S-enantiomer of propivacaine and is marketed under brand names such as Naropin. It is designed to offer a favorable safety profile compared with some older local anesthetics.

Mechanism and properties

Ropivacaine exerts its effect by blocking voltage-gated sodium channels in nerve membranes, preventing the initiation and propagation of action potentials. This produces sensory blockade (analgesia) with variable motor blockade. It has relatively lower lipid solubility and is less cardiotoxic than some related agents, contributing to a wider margin of safety in many clinical situations. Onset of anesthesia is generally slower than lidocaine, but the duration of effect is extended.

Medical uses

Ropivacaine is used for neuraxial anesthesia (epidural and, less commonly, spinal) and for peripheral nerve blocks. It is commonly employed for intraoperative analgesia, postoperative pain control, and obstetric analgesia. Concentrations and volumes vary by technique; it is frequently prepared with or without a vasoconstrictor such as epinephrine to prolong duration and reduce systemic absorption.

Pharmacokinetics and safety

Ropivacaine is primarily cleared by hepatic metabolism, with inactive metabolites excreted in urine. The drug has high protein binding and variable duration depending on route and patient factors, including liver function. Adverse effects can include central nervous system symptoms (dizziness, tinnitus, seizures) and cardiovascular toxicity if injected intravascularly or absorbed rapidly. Allergic reactions are uncommon. Careful dosing and monitoring are advised, especially in pregnancy, pediatrics, and patients with hepatic impairment.

History

Ropivacaine was developed as a less cardiotoxic alternative to bupivacaine and was introduced in the 1990s. It remains widely used for regional anesthesia and pain management worldwide.