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Ropivacaine is one of the most common but toxic local anaesthetics, and the mechanisms underlying its neurotoxicity are still largely unknown. This study was conducted to prepare a ropivacaine-induced neuronal injury model and research the effects of ropivacaine on PARP-1 activation and nicotinamide adenine dinucleotide ( NAD)+ depletion. The cell death and apoptosis of ropivacaine-induced SH- SY5Y cells were detected with flow cytometry. The lactate dehydrogenase cycling reaction measured the NAD+ level, and western blots were used to analyze the expression levels of PARP-1 and apoptosis-inducing factor ( AIF) after ropivacaine treatments with different concentrations and durations. A PARP-1 inhibitor ( PJ-34) was used to confirm the relationship between PARP-1 activation and NAD+ depletion. Hoechst 33258 nuclear staining and a mitochondrial membrane potential (Δψm) assay were used to detect the role of exogenous NAD+ in ropivacaine-induced neuronal injury. Ropivacaine-induced SH- SY5Y cell death and apoptosis, PARP-1 activation, and AIF increase as well as intracellular NAD+ depletion occurred in a time- and concentration-dependent manner ( P<.05). PARP-1 activation led to NAD+ depletion ( P<.05). Exogenous NAD+ impaired ropivacaine-induced nuclear injury ( P<.05). Ropivacaine treatment induced PARP-1 activation and NAD+ depletion ( P<.05). Parthanatos ( PARP-1-dependent cell death) was definitely involved in ropivacaine-induced neuronal injury, and exogenous NAD+ may be a novel therapeutic method for parthanatos-dependent neuronal injury. [ABSTRACT FROM AUTHOR]