Pharmacology for Anaesthesia and Intensive Care

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Section IICoredrugs in anaesthetic practice

CH 3

CH 3

CH 3

CH 3

CH 3

CH 3

CH (^3) CH
3
CH 3
CH 2
CH 3
CH 3
C 4 H 9 NH
C 3 H 7
N(C 2 H 5 ) 2
C 3 H 7

C—O— CH 2 CH 2 — N(CH 3 ) 2

C

CO

O

O

O

N

NC

O N

N

O

H

H

NC

H O

CH 3

CH 3

C 4 H 9

N

NC

H O

HO

NC

HO

NC

C

HH

N

H

Mepivacaine

Cocaine

Amethocaine

Prilocaine

Lidocaine

Ropivacaine

Bupivacaine

Figure 10.3.Structure of some local anaesthetics. Asterisk marks chiral centre.

would appear more appropriate than bupivacaine for epidural infusion due to its

sensory/motor discrimination and greater clearance.

Kinetics

Ropivacaine is metabolized in the liver by aromatic hydroxylation, mainly to 3-

hydroxy-ropivacaine, but also to 4-hydroxy-ropivacaine, both of which have some

local anaesthetic activity.