Ropivacaína

Ropivacaína: Una revisión de su farmacología y uso clínico  Ropivacaine: A review of its pharmacology and clinical use. Kuthiala G, Chaudhary G. Indian J Anaesth [serial online] 2011 [cited 2012 Jun 21];55:104-10. Ropivacaine is a long-acting amide local anaesthetic agent and first produced as a pure enantiomer. It produces effects similar to other local anaesthetics via reversible inhibition of sodium ion influx in nerve fibres. Ropivacaine is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in a relatively reduced motor blockade. Thus, ropivacaine has a greater degree of motor sensory differentiation, which could be useful when motor blockade is undesirable. The reduced lipophilicity is also associated with decreased potential for central nervous system toxicity and cardiotoxicity. The drug displays linear and dose proportional pharmacokinetics (up to 80 mg administered intravenously). It is metabolised extensively in the liver and excreted in urine. The present article details the clinical applications of ropivacaine and its current place as a local anaesthetic in the group http://www.ijaweb.org/text.asp?2011/55/2/104/79875   Efecto de la solución calentada de ropivacaína sobre el inicio y duración del bloqueo axilar  Effect of warmed ropivacaine solution on onset and duration of axillary block. Lee R, Kim YM, Choi EM, Choi YR, Chung MH. Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. Korean J Anesthesiol. 2012 Jan;62(1):52-6. Epub 2012 Jan 25. Abstract BACKGROUND: Bicarbonate, as an adjunct increasing the non-ionized form of local anesthetics, can reduce latency and prolong duration of regional nerve block. Warming of local anesthetics decreases pKa and also increases the non-ionized form of local anesthetics. We warmed ropivacaine to body temperature (37 C) and evaluated the sensory block onset time, motor block onset time and analgesic duration of axillary block. METHODS: Patients were consecutively allocated to two groups of 22 patients each. Ropivacaine 150 mg (30 ml) at 20  (room temperature) and 150 mg (30 ml) at 37  (body temperature) was injected in group 1 and group 2, respectively. Sensory block and motor block was assessed every 5 minutes, for 30 minutes after injection. The duration of analgesia was recorded after operation. RESULTS: In group 2, the onset times of both sensory and motor block of the radial, ulnar, median and musculocutaneous nerves were significantly reduced, compared to group 1. Also, the number of blocked nerves was increased in group 2, within 30 minutes after injection. Analgesia lasted for 2 hours longer in group 2, compared to group 1, but the difference was not statistically significant (P > 0.05). CONCLUSIONS: Warming of ropivacaine to 37  can reduce the onset time of both sensory and motor block, during axillary block http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-62-52.pdf

Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org