Background Ropivacaine is an amide local anesthestic. It is not a new drug. This drug has the specificity to be less cardiotoxic, with reduced motor blockade, and can be used for regional anaesthesia such as epidural anaesthesia in the delivery room.
In July 2017, it was decided by the pharmaceutical services in Rambam Health Care Campus, together with the anaesthesiologist, to switch to the use of ropivacaine as an alternative to bupivacaine, which had been used for many years in the delivery room.
Purpose The transition from the use of bupivacaine to the use of ropivacaine for the purpose of regional anaesthesia in the delivery room, was carried out in order to achieve a better analgesic effect with minimal motor paralysis compared to bupivacaine.
Material and methods Ropivacaine is commercially available as a solution of 0.2% (200 mg/100 ml bag). In order to reduce the concentration to 0.1%, the hospital pharmacy added 85 ml of normal saline and 10 ml (0.5 mg) of fentanyl to each ropivacaine bag.
The preparation was done using the aseptic technique, labelled and stored in a refrigerator at 2°C–8°C, and given a shelf-life of 14 days.
Approximately 300 preparations were prepared each month, and supplied to the delivery room.
Results The administration of low-dose ropivacaine 0.1% over the same time as an alternative to the administration of bupivacaine at a concentration of 0.125% gave a very good analgesic effect. In addition, ropivacaine has a reduced motor block in comparison to bupivacaine, which has significant motor block.
Conclusion The administration of low-dose ropivacaine (0.1%) as a substitute for bupivacaine (0.125%) gave a very good analgesic effect. In addition, the anaesthesiologists observed a reduction in motor blockade using ropivacaine in comparison to that of bupivacaine.
References and/or acknowledgements The author thanks the pharmacist team of Rambam Hospital for their assistance in the technical work of sterile preparations.
No conflict of interest.
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