ROPIVACAINE HYDROCHLORIDE IS GIVEN IN CONCENTRATIONS OF 0.2 TO 1%. THE DOSAGE DEPENDS ON THE SITE OF INJECTION AND THE PROCEDURE USED, AS WELL AS THE STATUS OF THE PATIENT. THE DOSE OF ROPIVACAINE SHOULD BE REDUCED IN THE ELDERLY, AND IN ACUTELY ILL OR DEBILITATED PATIENTS. A TEST DOSE OF LIDOCAINE WITH ADRENALINE SHOULD BE GIVEN BEFORE STARTING EPIDURAL BLOCK WITH ROPIVACAINE TO DETECT INADVERTENT INTRAVASCULAR ADMINISTRATION.
FOR SURGICAL ANAESTHESIA, DOSES OF ROPIVACAINE HYDROCHLORIDE FOR LUMBAR EPIDURAL BLOCK ARE 75 TO 150 MG (15 TO 30 ML) AS A 0.5% SOLUTION, OR 112.5 TO 187.5 MG (15 TO 25 ML) AS A 0.75% SOLUTION, OR 150 TO 200 MG (15 TO 20 ML) AS A 1% SOLUTION; FOR CAESAREAN SECTION, DOSES ARE 100 TO 150 MG (20 TO 30 ML) AS A 0.5% SOLUTION OR 112.5 TO 150 MG (15 TO 20 ML) AS A 0.75% SOLUTION. DOSES FOR THORACIC EPIDURAL BLOCK TO ESTABLISH A BLOCK FOR POSTOPERATIVE PAIN RELIEF ARE 25 TO 75 MG (5 TO 15 ML) AS A 0.5% SOLUTION OR 37.5 TO 112.5 MG (5 TO 15 ML) AS A 0.75% SOLUTION; THE ACTUAL DOSE USED DEPENDS ON THE LEVEL OF THE INJECTION.
FOR PERIPHERAL NERVE BLOCK OF MAJOR NERVES SUCH AS THE BRACHIAL PLEXUS, TYPICAL DOSES ARE 175 TO 250 MG (35 TO 50 ML) AS A 0.5% SOLUTION; 225 TO 300 MG (30 TO 40 ML) AS A 0.75% SOLUTION HAS ALSO BEEN RECOMMENDED FOR BRACHIAL PLEXUS BLOCK.
FOR INFILTRATION ANAESTHESIA AND FIELD BLOCK UP TO 200 MG (40 ML) AS A 0.5% SOLUTION OR UP TO 225 MG (30 ML) AS A 0.75% SOLUTION MAY BE USED.
IN THE MANAGEMENT OF ACUTE PAIN ROPIVACAINE HYDROCHLORIDE IS USED AS A 0.2% SOLUTION FOR EPIDURAL BLOCK (0.5% SOLUTIONS MAY BE USED FOR INFILTRATION). DOSES FOR LUMBAR EPIDURAL BLOCK ARE 20 TO 40 MG (10 TO 20 ML) AS AN INITIAL BOLUS FOLLOWED BY 20 TO 30 MG (10 TO 15 ML) AT INTERVALS OF NOT LESS THAN 30 MINUTES. ALTERNATIVELY, 12 TO 20 MG (6 TO 10 ML) PER HOUR MAY BE GIVEN AS A CONTINUOUS EPIDURAL INFUSION; IF ADDITIONAL PAIN RELIEF IS REQUIRED, DOSES OF UP TO 28 MG (14 ML) PER HOUR MAY BE GIVEN. DOSES FOR THORACIC EPIDURAL BLOCK ARE 12 TO 28 MG (6 TO 14 ML) PER HOUR AS A CONTINUOUS INFUSION.
FOR INFILTRATION ANAESTHESIA DOSES ARE 2 TO 200 MG (1 TO 100 ML) AS A 0.2% SOLUTION OR 5 TO 200 MG (1 TO 40 ML) AS A 0.5% SOLUTION.
IN CHILDREN AGED 1 YEAR AND OVER, ROPIVACAINE HYDROCHLORIDE MAY BE USED FOR THE MANAGEMENT OF PRE- AND POSTOPERATIVE PAIN. A 0.2% SOLUTION IS GIVEN IN DOSES OF 2 MG/KG (1 ML/KG) TO ACHIEVE A CAUDAL EPIDURAL BLOCK.