Dosing & Uses
Dosage Forms & Strengths
75-200 mg (15-30 mL of 0.5%-1% solution)
Major Nerve Block
175-250 mg (35-50 mL) of 0.5% solution
5-200 mg (1-40 mL) of 0.5% solution
20-40 mg (10-20 mL) initial, THEN
20-30 mg/hr (10-15 mL/hr) continuous infusion of 0.2% solution
8-16 mg/hr (4-8 mL/hr) thoracic continuous infusion of 0.2% solution
Doses should not be repeated more frequently than q3hr, no more than 400 mg (770 mg for post-op pain) in 24 hr
<12 years old: not recommended
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Bradycardia, myocardial depression, , cardiac arrhythmias, edema, hypotension, cardiovascular collapse, cardiac arrest, palpitation, tachycardia, anginal pain, hypertension (epinephrine-containing solutions)
Anxiety, apprehension, chills, headache, restlessness, nervousness, disorientation, confusion, dizziness, tremors, twitching, shivering, seizures; CNS depression manifested restlessness, tremors, drowsiness, unconsciousness, tinnitus
Blurred vision, miosis
Respiratory arrest, status asthmaticus
Anaphylactoid reactions (sometimes fatal)
Hypersensitivity to ropivacaine or amide-type local anesthetics, sensitivity to parabens
Obstetrical paracervical block anesthesia
History of malignant hyperthermia
DO NOT use solutions with epinephrine in distal areas of body (eg, digit, nose, ear)
Use preservative-free preparations for spinal or epidural anesthesia
Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action
Chondrolysis associated with intra-articular infusions following arthroscopic and other surgical procedures (off-label use)
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Duration: greater the degree of vasodilation produced by the local anesthetic, faster the rate of absorption & shorter the duration of action
Protein bound: highly
Metabolites: ester- & amide-type local anesthetics
Excretion: urine (principally)
Mechanism of Action
Local anesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability & increasing action potential threshold
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