羅哌卡因
羅哌卡因是一種長效醯胺類局部麻醉劑，用於透過神經阻滯、區域和硬膜外技術提供鎮痛。與布比卡因相比，羅哌卡因的心臟毒性較低，且對感覺神經的選擇性高於運動神經，從而減少了相關的運動神經阻滯程度。絕對不可靜脈注射，以免引發難以治療的嚴重心律不整。
作用機制: Ropivacaine produces local anesthesia through the **reversible blockade of voltage-gated sodium channels** in nerve fibers. By binding to the intracellular portion of sodium channels, it prevents sodium influx → inhibits depolarization → prevents the generation and conduction of action potentials along the nerve fiber. Its higher lipid solubility allows it to preferentially block A-delta and C fibers (sensory/pain) over A-alpha fibers (motor).
各物種劑量
- Analgesia (perineural, epidural, or intrapleural) · Up to 4 mg/kg · Perineural/Epidural/Intrapleural · q8h · Lower doses should be used when systemic absorption is likely to be high (e.g., intrapleural). Can be diluted with normal saline for wider distribution.
- Analgesia · Maximum 2 mg/kg · Perineural/Epidural/Intrapleural · The toxic dose has not been established in cats; it is recommended not to exceed 2 mg/kg.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
給藥途徑
禁忌症
- Intravenous (IV) administration
- Intravenous regional anaesthesia (Bier block)
不良反應
- Cardiac arrhythmias (if injected intravascularly)
- Systemic toxicity (CNS excitation followed by depression, seizures)
- Motor blockade (dose-dependent)
藥物相互作用
- Other local anaesthetics · Additive systemic toxicity; dose of ropivacaine should be reduced when used in combination. · major
- Adrenaline (Epinephrine) · Unlike some other local anesthetics, the addition of adrenaline does not appear to significantly alter the duration of the ropivacaine block. · null
監測
- Heart rate and rhythm (ECG)
- Blood pressure
- Signs of CNS toxicity (twitching, tremors, seizures)
- Motor function recovery
過量
Overdosage or inadvertent intravascular injection can lead to severe systemic toxicity. * **Cardiovascular:** May precipitate severe cardiac arrhythmias that are highly refractory to standard treatments, hypotension, and cardiovascular collapse. * **CNS:** May cause excitation, tremors, and seizures, followed by CNS depression. * **Treatment:** Supportive care, oxygen therapy, seizure control (e.g., benzodiazepines), and potentially intravenous lipid emulsion (ILE) therapy for severe toxicity.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。