Long-acting amide local anaesthetic
Ropivacaine hydrochloride
Brand names: Naropin
Adult dose
Dose: Epidural surgical: 15–25mL of 0.5–0.75%. Labour epidural: 0.1–0.2% infusion 6–12 mL/h. Peripheral block: 0.5–0.75% 30–40mL. Max 3 mg/kg
Route: Infiltration/epidural/peripheral
Frequency: per block
Clinical pearls
- Long-acting LA with motor sparing at low concentrations — ideal for labour epidural and continuous blocks
- Lower cardiotoxicity than bupivacaine
Contraindications
- Hypersensitivity to amides
- Bacteraemia (neuraxial)
- Coagulopathy (neuraxial)
- Hypotension
- Site infection
Side effects
- CNS toxicity (high doses)
- Cardiovascular collapse (less than bupivacaine)
- Local nerve damage
- Methaemoglobinaemia (rare)
Interactions
- Other LAs (additive toxicity)
- β-blockers
- Class III antiarrhythmics
Monitoring
- BP
- HR
- CNS
Reference: BNF; AAGBI safe practice; https://bnf.nice.org.uk/drugs/ropivacaine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators