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Biomedical subjects

M M Juneja

Publications and source records attributed to M M Juneja.

27 records · Page 2Linked to original sources
PubMed1989

The effect of pH and PCO2 on epidural analgesia with 2% 2-chloroprocaine.

Increasing the pH of local anesthetics with sodium bicarbonate has been reported to hasten their onset of action. The purpose of this study was to compare the onset and duration of epidural analgesia with the use of sodium bicarbonate and tromethamine to increase the pH of 2% chloroprocaine (2CP). Five groups of patients were studied: Group I received 2CP; Group II received 2CP buffered to a pH of 7.1 with tromethamine; Group III received 2CP buffered to a pH of 7.1 with sodium bicarbonate; Group IV received 2CP buffered to a pH of 7.7 with tromethamine; and Group V received 2CP buffered to a pH of 7.7 with sodium bicarbonate. The final pH and PCO2 of each solution were measured. Time to onset of analgesia was significantly delayed with either of the tromethamine buffered groups (II [5.6 +/- 1.0 minutes] and IV [5.4 +/- 0.4 minutes]) when compared with data from the unbuffered control (I [4.4 +/- 0.1 minutes]) and the sodium bicarbonate buffered (III [4.5 +/- 0.8 minutes] groups and Group V [2.7 +/- 0.9 minutes]). Only when sodium bicarbonate buffer adjusted to pH 7.7 (Group IV) was onset significantly more rapid than the unbuffered 2CP (I) and tromethamine buffered 2CP (II and IV). Multiple regression analysis revealed that onset times were significantly related to both pH and PCO2. The coefficient of determination for this model was 0.5156.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Use of a pulmonary artery catheter in the management of the severe preeclamptic patient.

The perioperative management of the parturient with severe preeclampsia can be challenging with reference to fluid and antihypertensive therapy. A pulmonary artery catheter should be used when necessary to provide accurate information concerning the patient's hemodynamic status and to provide additional information regarding the effectiveness of the therapeutic modalities employed.

Adult↗
PubMedDate not supplied

Alkalinization of chloroprocaine for epidural anesthesia: effects of pCO2 at constant pH.

Increasing the pH of 2% chloroprocaine (CP) with sodium bicarbonate to pH 7.7 hastens the onset of epidural analgesia. The purpose of the present study was to determine the effect of pCO2 on the onset of epidural analgesia with CP buffered to a constant pH 7.7. Four groups consisting of ten patients each were studied: C, control, commercial CP (pH 4.35); B, CP buffered with sodium bicarbonate (pH 7.7); T, CP buffered with tromethamine (pH 7.7), and BT, CP buffered with sodium bicarbonate and tromethamine (pH 7.7). All epidural catheters were placed at the L2-3 or L3-4 interspace using a loss-of-resistance technique with air with each patient in a sitting position. The pH and pCO2 of each local anesthetic solution were measured as well as the onset and duration of analgesia. The study groups did not differ with respect to demography or entry characteristics. There were intergroup differences in the pCO2 values of the study solutions as follows: Group 1 (C), 11.8 +/- 1.5 mmHg; 2 (B), 113.0 +/- 1.4 mmHg; 3 (T), 3.0 +/- 0.3 mmHg, and 4 (BT), 74.1 +/- 1.0 mmHg, respectively. The time to the onset of analgesia was significantly faster in Group 2 (B; 2.7 +/- 0.8 minute), while the onset of analgesia was significantly slower for Group 3 (T; 5.4 +/- 0.4 minute) than either Group 1 (C; 4.2 +/- 0.8 minute) or Group 4 (BT; 3.4 +/- 0.3 minute). Regression analysis revealed that the onset times of the buffered solutions were significantly related to pCO2 (r2 = 0.81).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗