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This is a combination of three active pharmaceutical ingredients—ropivacaine, ketorolac, and adrenaline (also known as epinephrine)—used primarily for local infiltration analgesia (LIA) in surgical settings such as total knee arthroplasty. - **Ropivacaine** is a long-acting amide-type local anesthetic that blocks nerve impulse transmission by inhibiting sodium channels in neuronal membranes. - **Ketorolac** is a non-steroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase enzymes (COX-1 and COX-2), reducing prostaglandin synthesis to provide analgesic and anti-inflammatory effects. - **Adrenaline/Epinephrine** acts as a vasoconstrictor via stimulation of alpha-adrenergic receptors, which reduces systemic absorption of the other agents at the injection site, prolongs their effect locally, and minimizes bleeding. This combination is used to provide effective postoperative pain control with reduced opioid requirements and improved early mobilization after surgery[1][3][4]. The addition of ketorolac enhances analgesia compared to ropivacaine plus adrenaline alone[1]. Adrenaline slows systemic absorption of the anesthetic and NSAID while prolonging their action at the site[4].
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