The place of ropivacaine in anesthesia.
Ropivacaine has two advantages over bupivacaine. It provides more differential block when given epidurally, allowing for a better separation between sensory and motor block. This feature can be used to its advantage in obstetrics and in postoperative epidural pain relief. Ropivacaine has a lower systemic toxicity than both racemic and levobupivacaine. Especially its better cardiotoxic profile has been well documented and is an important advantage when using techniques with a potential for high plasma concentrations. Ropivacaine is less potent than bupivacaine and has a shorter duration of action. The magnitude of this potency difference however is not clearly quantified and differs with varying techniques. In some studies, the potency difference amounts up to 50% whereas in other studies the difference is negligible. The lower systemic toxicity of ropivacaine compared to bupivacaine is not offset by a lower potency, as ropivacaine in a 50% higher dose is still less cardiotoxic.
Stienstra
R
R
Dept. of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.
D000577:Amides / Q000009:adverse effects / Q000627:therapeutic use*; D000758:Anesthesia; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D004341:Drug Evaluation; D006801:Humans; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine