From the FDA Drug Label
A total of 7 clinical studies were performed to evaluate the local infiltration of Ropivacaine hydrochloride injection to produce anesthesia for surgery and analgesia in postoperative pain management. In these studies 297 patients who received Ropivacaine hydrochloride in doses up to 200 mg (concentrations up to 5 mg/mL, 0. 5%) were evaluable for efficacy. With infiltration of 100 to 200 mg Ropivacaine hydrochloride, the time to first request for analgesic was 2 to 6 hours. When compared to placebo, Ropivacaine hydrochloride produced lower pain scores and a reduction of analgesic consumption
The effect of ropivacaine wound infiltration is to produce anesthesia for surgery and analgesia in postoperative pain management. The infiltration of 100 to 200 mg of ropivacaine results in a time to first request for analgesic of 2 to 6 hours and produces lower pain scores and a reduction of analgesic consumption compared to placebo 1.
From the Research
Introduction to Ropivacaine Wound Infiltration
Ropivacaine is a local anesthetic that has been widely used for postoperative pain management. Its effectiveness in wound infiltration has been studied in various clinical settings.
Effects of Ropivacaine Wound Infiltration
The effects of ropivacaine wound infiltration include:
- Improved pain relief at rest, as seen in patients undergoing open hepatectomy 2 and thoracotomy surgery 3
- Reduced opioid consumption, as observed in patients undergoing transforaminal lumbar interbody fusion 4 and open hepatectomy 2
- Faster recovery and shorter hospital stays, as noted in patients undergoing thoracotomy surgery 3 and open hepatectomy 2
- Earlier ambulation and bowel recovery, as seen in patients undergoing thoracotomy surgery 3 and open hepatectomy 2
Treatment and Dosage
The recommended dosage of ropivacaine for wound infiltration varies depending on the surgical procedure and the patient's condition. However, dosages ranging from 100-300 mg have been used in various studies 5, 6. The treatment duration also varies, but continuous infusion or repeated injections can be used to maintain adequate pain relief.
Differentials and Caveats
It is essential to consider the following differentials and caveats when using ropivacaine wound infiltration:
- Ropivacaine has a lower systemic toxicity compared to bupivacaine, making it a safer option for patients 5
- The efficacy of ropivacaine may be similar to that of bupivacaine, but with less motor blockade and stronger vasoconstriction at low concentrations 5
- The cost of ropivacaine may be higher than that of bupivacaine, which may limit its clinical utility in some settings 5
Conclusion
Ropivacaine wound infiltration is a effective adjunct to postoperative pain management, providing improved pain relief, reduced opioid consumption, and faster recovery. However, it is crucial to consider the treatment dosage, duration, and potential differentials and caveats to ensure optimal patient outcomes.