Ropivacaine is safe in renal failure. Although a metabolite of

ropivacaine (pipecoloxylidide) may accumulate in plasma during

long-term postoperative infusions, in particular in patients with

coexisting low non-renal elimination, its systemic toxicity is

markedly less than ropivacaine.

Ref

Pere PJ, Ekstrand A, Salonen M, et al. Pharmacokinetics of ropivacaine

in patients with chronic renal failure. Br J Anaesth. 2011;106(4):512–21.

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