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This is a combination drug consisting of three active pharmaceutical ingredients: - **Ropivacaine**: an amide-type local anesthetic that blocks nerve impulse transmission by inhibiting sodium channels, providing regional anesthesia and analgesia. - **Fentanyl**: a potent synthetic opioid agonist at the mu-opioid receptor, used for its strong analgesic properties. - **Adrenaline (epinephrine)**: a sympathomimetic agent that acts primarily on alpha and beta adrenergic receptors. When added to local anesthetics in epidural or regional anesthesia, it causes vasoconstriction at the injection site, which slows systemic absorption of the anesthetic and opioid, prolongs their effect, and may reduce toxicity. This combination is commonly used in epidural infusions for postoperative pain management after major surgeries such as knee arthroplasty or abdominal surgery. The addition of adrenaline/epinephrine aims to enhance analgesia by reducing vascular uptake of both ropivacaine and fentanyl[1][4]. However, clinical studies have shown mixed results regarding whether adding adrenaline significantly improves pain relief compared to ropivacaine plus fentanyl alone[1][4].
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