gasguide

Ropivacaine

Naropin

Amide local anesthetic, long-acting

S-enantiomer of propivacaine. Less lipid-soluble than bupivacaine → less cardiotoxicity but slightly less potency.

Indications

  • Peripheral nerve blocks
  • Epidural
  • Wound infiltration

Dosing

ContextAdultPediatric
Epidural0.2–0.5% bolus; 0.1–0.2% infusion
Peripheral block0.5–0.75% 20–40 mL
Local infiltrationMax 3 mg/kg plain

Pharmacokinetics

Onset 5–15 min. Duration 4–8 h. Hepatic CYP1A2 + CYP3A4.

Side effects

  • !LAST (less than bupivacaine but still possible)
  • !Motor-sparing at low concentrations (useful for OB labor + ambulatory)

Contraindications

  • ×Bier block

Clinical pearls

  • Better motor/sensory differential than bupivacaine — preferred for labor epidurals at 0.0625–0.1%.
  • Slightly less potent than bupivacaine — may need 1.2–1.5× dose for equivalent block.
Education only — confirm against current package inserts and institutional protocols. Doses assume normal organ function unless otherwise noted.