Studying Naropin: A Commonly Used Anesthetic in Anesthesiology
Today, we will learn about Naropin, an anesthetic frequently used in anesthesiology.
What is Naropin?
Naropin’s active ingredient is calle
d ropivacaine, which comes in a plastic ampule filled with a colorless, transparent liquid. It is available at a concentration of 7.5 mg per 1 ml.
Naropin is an amide-type, long-acting local anesthetic commonly used in clinical settings for the following purposes:
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- Epidural infusion for pain relief during labor or cesarean section (often used with epidural PCA for gradual administration of anesthetics to alleviate pain during childbirth).
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- Local or regional anesthesia, numbing a specific area to reduce the sensation of surgery on that part.
- Postoperative local anesthesia to relieve pain during the recovery process, especially after major abdominal surgeries, through TAP Block (Transversus Abdominis Plane) or BPB Block (Brachial Plexus Block), where local anesthetics are applied to nerve areas under ultrasound guidance.
Dosage and Administration
The dosage guidelines recommend the following:
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- The total dose of ropivacaine should not exceed 225 mg when additional doses are given to the same patient.
- When performing epidural anesthesia, a test dose of a solution containing adrenaline should be administered to observe for signs of increased heart rate or spinal block, ensuring the drug is not being injected into a blood vessel or outside the epidural space.
Precautions
This drug should be used under the supervision of a specialist experienced in local anesthesia, or at least under their guidance. The minimum effective amount should be administered. In general, higher concentrations and doses are used for surgical anesthesia, while lower concentrations and doses are preferred for pain relief purposes.
For surgical anesthesia, high concentrations and high doses are often administered via what is clinically called a “shot block,” ensuring the patient feels no pain during the procedure. For pain relief, such as in labor, the drug is administered through a gradual infusion using a low concentration and dose to reduce labor pain.
There is a risk of unintended intravascular injection or subarachnoid administration, which may lead to cardiac arrest or severe arrhythmias. When using this drug, it is essential to administer it slowly, increasing the dosage incrementally over time, and avoid rapid injection of large amounts.
Medical professionals capable of diagnosing and treating toxic reactions, and handling emergencies related to nerve blocks, should be present. Equipment for immediate oxygen supply, resuscitation drugs, and defibrillators must also be readily available.
Common Side Effects
The main side effects of Naropin include cardiovascular symptoms like hypotension and bradycardia, as well as gastrointestinal symptoms such as nausea and vomiting. Less common side effects include chest pain, hypertension, tachycardia, headache, pain, paresthesia, dizziness, chills, anxiety, itching, muscle spasms, and tinnitus.
Contraindications
This drug should not be used in the following patients:
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- Patients allergic to amide-type anesthetics
- Patients in shock
- Patients with central nervous system disorders
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- Patients with inflammation at the injection site
- Patients with coagulation disorders or those taking anticoagulants
>Epidural