Ropivacaine

When ATH:
N01BB09

Pharmacological action.
Mestnoanesteziruyuschee.

Application.

Local anesthesia: Epidural, incl. for caesarean section, wires (including major nerves and plexus), infiltration; relief of acute pain (incl. postoperative analgesia and anesthesia delivery).

Contraindications.

Hypersensitivity, Age to 12 years (there is no sufficient number of clinical observations).

Restrictions apply.

Heart block (Partial or complete), cirrhosis of the liver, renal failure.

Pregnancy and breast-feeding.

With care during pregnancy and breastfeeding (It passes into breast milk). Application for anesthesia or analgesia in obstetrics justified.

Side effects.

Hypo- or hypertension, Beards- or tachycardia, headache, dizziness, paraesthesia, neuropathy, dysfunction of the spinal cord (anterior spinal artery syndrome, araxnoidit), nausea, vomiting, chills, fever, urinary retention, allergic reactions (incl. anaphylactic shock).

Cooperation.

Enhances toxic effects etc.. drugs and local anesthetics, structurally similar to local anesthetics of the amide type. Strengthens (mutually) action funds, CNS depressants.

Overdose.

Symptoms: impaired vision and hearing, gipotenziya, arrhythmia, dysarthria, increased muscle tone, vellication; the progression of intoxication: loss of consciousness, convulsions, gipoksiya, giperkapniя, respiratory and metabolic acidosis, dyspnoea, apnea, cardiac arrest.

Treatment: cessation of administration, maintaining adequate oxygenation, arresting convulsions and seizures (assignment thiopental 100-120 mg / w diazepam or 5-10 mg / in); if necessary - IVL (after the start of the ventilator can be administered suxamethonium), normalization of blood circulation, Correction of acidosis; the development of hypotension and bradycardia - the introduction of ephedrine 5-10 mg / in (perhaps again after 2-3 minutes).

Dosing and Administration.

0,2% solution. Relief of acute pain: lumbar epidural level - bolus - 10-20 ml (20-40 Mg); intermittent administration (pain during childbirth) - 10-15 ml (20-30 Mg) minimum interval 30 m; continuous infusion for labor analgesia - 6-10 ml / h (12-20 Mg / h); postoperative administration - 6-14 ml / h (12-28 Mg / h); Thoracic epidural analgesia: Continuous infusion after operations - 6-14 ml / h (12-28 Mg / h); conduction and infiltration anesthesia - 1-100 ml (2-200 Mg).

0,75% solution. Anesthesia for surgery. Cesarean section - 15-20 ml (113-150 Mg); Thoracic epidural anesthesia for postoperative pain - 5-15 ml (38-113 Mg); lumbar epidural level - 15-25 ml (113-188 Mg); conduction and infiltration anesthesia - 1-30 ml (7,5-225 Mg); major nerve plexus blockade (brachial) - 10-40 ml (75-300 Mg).

1% solution. Anesthesia for surgery: lumbar epidural level - 15-20 ml (150-200 Mg).

Precautions.

Patients with severe liver disease should be reduced repeated doses. It is necessary to take into account, that ropivacaine violates motor function, coordination and reaction speed. Therefore, after the application period, after which the patient can do the job, requires more attention, determined by a physician.

During the prolonged blockade (infusion or repeated bolus) can be created toxic anesthetic concentration in blood and local nerve damage.

Cautions.

Prior to anesthesia should be installed intravenous catheters and to ensure that resuscitation equipment. Prior to and during administration (a rate of 25-50 mg / m) aspiration is necessary to conduct test (for the prevention of intravascular contact solution, which can be recognized by an increase in heart rate).