Ropivacaine Hydrochloride

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1.Overview:
Bupivacaine (rINN) is a local anaesthetic drug belonging to the amino amide group. It is commonly marketed under various trade names, including Marcain (Astra Zeneca UK), Marcaine (Carestream Dental, Hospira Inc.), Sensorcaine (Astra Zeneca), and Vivacaine (Septodont). It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.
2. Medical uses:
Bupivacaine is indicated for local infiltration, peripheral nerve block, sympathetic nerve block, and epidural and caudal blocks. It is sometimes used in combination with epinephrine to prevent systemic absorption and extend the duration of action. The 0.75% (most concentrated) formulation is used in retrobulbar block. It is the most commonly used local anesthetic in epidural anesthesia during labor, as well as in postoperative pain management.
3. Treatment of overdose:
Further information: Lipid rescue
Animal evidence indicates intralipid, a commonly available intravenous lipid emulsion, can be effective in treating severe cardiotoxicity secondary to local anaesthetic overdose, and human case reports of successful use in this way. Plans to publicize this treatment more widely have been published.
4. Mechanism of action:
Bupivacaine binds to the intracellular portion of voltage-gated sodium channels and blocks sodium influx into nerve cells, which prevents depolarization. Without depolarization, no initiation or conduction of a pain signal can occur.