Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of intrathecal morphine for analgesia following elective cesarean section: comparison with previous delivery.
To determine the effect of intrathecal injection of morphine 0.2 mg on postoperative analgesia, activity and satisfaction after elective cesarean section. ⋯ The addition of morphine 0.2 mg to hyperbaric bupivacaine 0.5% by intrathecal injection reduced postoperative pain and analgesic use, and increased patient satisfaction following cesarean section. The combination of intrathecal injection of morphine and preventive NSAIDs can be easily administered in most hospitals, and is substantially less expensive than the new pain management technologies currently in use.
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Randomized Controlled Trial Clinical Trial
[Clinical significance of a standardized clinical pathway in gastrectomy patients].
In traditional practice patterns, physicians take care of all clinical decisions, such as diagnosis, treatment, and recovery. In the Nippon Medical School Hospital a clinical pathway for distal gastrectomy patients, recorded as a post-operative care map, was introduced in August 2000. In January 2001 the post-operative management was analyzed and standardization of practice was carried out with printed order sets, such as drugs and infusion solutions. The aim of this study was to evaluate the clinical significance of the clinical pathway for gastrectomy patients by employing standardized postoperative management and printed order sets. ⋯ A clinical pathway for gastrectomy patients proved useful to optimize their postoperative care, including medication management and diet education. It is suggested that the implementation of a standardized clinical pathway for gastrectomy patients reduced the length of the hospital stay and the medical costs.