Pharmacokinetics of ropivacaine in patients with chronic renal failure

The pharmacokinetics of ropivacaine is not affected by renal failure. Although the renal clearance of PPX correlates with CLCR, non-renal elimination seems to compensate for reduced renal clearance in most patients. PPX may accumulate in plasma during long-term postoperative infusions, in particular in patients with co-existing low non-renal elimination. Systemic toxicity is still unlikely because PPX is markedly less toxic than ropivacaine.