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ROPICAIN

ROPIVACAINE · by LCPW

ANAESTHETIC, LOCAL Alpha/Beta 2-agonist/Local anaesthetic LCPW

Composition

Inj: Per ml: Ropivacaine 2 mg/5 mg/7.5 mg/10 mg.

Indications & Dosage

Acute pain, peripheral nerve block: BY REGIONAL ADMINISTRATION: Adult: 10-20 mg/hour, dose administered as a continuous INF or by intermittent injection using a 2 mg/ml (0.2%) solution. Acute pain, field block: BY REGIONAL ADMINISTRATION: Adult: 2-200 mg, dose administered using a 2 mg/ml(0.2%) solution. Acute pain, lumbar epidural block: BY LUMBAR EPIDURAL: Adult: 20-40 mg, followed by 20-30 mg at least every30 minutes, dose administered using a 2 mg/ml (0.2%) solution. Acute labour pain: BY CONTINUOUS EPIDURAL INF: Adult: 12-20 mg/hour, dose administered using a2 mg/ml (0.2%) solution. Acute postoperative pain: BY CONTINUOUS EPIDURAL INF: Adult: Up to 28 mg/hour, dose administered using a2 mg/ml (0.2%) solution. Postoperative pain, thoracic epidural block: BY CONTINUOUS EPIDURAL INF: Adult: 12-28 mg/hour, dose administered using a2 mg/ml (0.2%) solution. Surgical anaesthesia, field block: BY REGIONAL ADMINISTRATION: Adult: 7.5-225 mg, dose administered using a7.5 mg/ml (0.75%) solution. Surgical anaesthesia, major nerve block (brachial plexus block): BY REGIONAL ADMINISTRATION: Adult: 225-300 mg, dose administered using a7.5 mg/ml (0.75%) solution. Surgical anaesthesia, thoracic epidural block (to establish block for postoperative pain): BY THORACIC EPIDURAL: Adult: 38-113 mg, dose administered using a7.5 mg/ml (0.75%) solution. Surgical anaesthesia for caesarean section: BY LUMBAR EPIDURAL: Adult: 113-150 mg, to be administered in incremental doses using a 7.5 mg/ml (0.75%) solution. Surgical anaesthesia, lumbar epidural block: BY LUMBAR EPIDURAL: Adult: 113-200 mg, dose administered using a7.5 mg/ml (0.75%) or 10 mg/ml (1%) solution.

Administration

Administered by lumbar epidural injection or infusion, by thoracic epidural infusion, by injection for nerve block, and by infiltration.

Stability

Stored at room temperature. Single use only, any remaining solution should be discarded promptly. The continuous infusion bottles should not be left in place for more than 24 hours.

Contraindications

Complete heart block, application to the middle ear (risk of ototoxicity), avoid injection into infected and inflamed tissues, preparations containing preservatives should not be usedfor caudal, epidural, or spinal block, or for intravenousregional anaesthesia (Biers block), should not be appliedto damaged skin

Precautions

Cardiovascular disease, debilitated patients, elderly, acute porphyrias, epilepsy, hypovolaemia, impaired cardiac conduction, impaired respiratory function,myasthenia gravis, shock, severe renal and hepatic impairment.

Pregnancy

No evidence of harm, do not use for paracervical block in obstetrics.

Lactation

Caution advised

Side Effects

Arrhythmias, pyrexia,blurred vision,hypertension, cardiac arrest,convulsions, dizziness,drowsiness, feeling of inebriation,headache, hypothermia, syncope, lightheadedness, muscle twitching, myocardial depression (resulting in hypotension and bradycardia),nausea, numbness of the tongue and perioral region, paraesthesia, peripheral vasodilatation, restlessness,tinnitus, transient excitation, drowsiness, respiratory failure, unconsciousness, tremors, vomiting