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This drug is a multi-component local infiltration analgesia (LIA) mixture developed for the management of postoperative pain following total joint arthroplasty, specifically total hip and knee replacements. The formulation consists of ropivacaine (a long-acting local anesthetic), ketorolac (a non-steroidal anti-inflammatory drug), epinephrine (a vasoconstrictor), and dexamethasone (a synthetic glucocorticoid). Ropivacaine provides regional anesthesia by inhibiting sodium channels in nerve fibers. Ketorolac offers additional analgesia by inhibiting prostaglandin synthesis. Epinephrine is included to induce local vasoconstriction, thereby slowing the systemic absorption of the other components and prolonging the duration of the local block. Dexamethasone is added to the mixture to further extend the analgesic effect and reduce postoperative inflammation and opioid consumption. This specific combination is being evaluated by the University Health Network, Toronto, to determine if the addition of dexamethasone improves functional outcomes compared to standard LIA mixtures.
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