Anatomy and Cell Biology

  • 제55권1호
  • /
  • Pages.48-54
  • /
  • 2022
  • /
  • 2093-3665(pISSN)
  • /
  • 2093-3673(eISSN)
대한해부학회 (Korean Association of Anatomists)
권호 표지
DOI QR코드

DOI QR Code

Evaluating the effectiveness of gluteal intramuscular injection sites: a cadaveric study

  • Yi-Suk Kim (Department of Anatomy, Catholic Institute for Applied Anatomy and College of Medicine, The Catholic University of Korea) ;
  • Yong Seok Nam (Department of Anatomy, Catholic Institute for Applied Anatomy and College of Medicine, The Catholic University of Korea) ;
  • Deog-Im Kim (Department of Nursing, College of Nursing, Keimyung University)
  • 투고 : 2021.11.07
  • 심사 : 2021.11.26
  • 발행 : 2022.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The gluteal region is a frequent target for injecting high volumes. However, the safe intramuscular injection sites have been controversy in this region. This study was aimed to compare the subcutaneous fat and muscle thicknesses at the two gluteal injection sites and to determine the influence of sex and body mass index (BMI) on fat and muscle thicknesses. The ultimate purpose of this study is to suggest the most suitable intramuscular injection site among the ventrogluteal and dorsogluteal regions. Eleven fresh cadavers were injected with colored gelatin using syringes at the two gluteal injection sites. Seven variables were measured at both gluteal injection sites and analyzed relative to sex and the BMI. No variables showed statistically significant differences between the two gluteal injection sites according to sex. In a one-way analysis of variance, total length and muscle thickness had significant difference according to the BMI category. In obese cadavers, the injected gelatin core was located in the subcutaneous layer (average 109.0 percentile), and in the muscle layer (average 78.9 percentile) in the dorsogluteal region. These were found that the success rate of injection in the dorsogluteal region was higher than in the ventrogluteal region, especially when classed as obese. Also, it is suggested that nurses should use the traditional intramuscular injection method. It will also be necessary to consider expanding these findings to other ethnic groups in the Asia-Pacific region and then also education in universities and health providers on selecting the intramuscular gluteal injection site.

키워드

과제정보

This work was supported by a research promotion from the Keimyung University Dongsan Medical Center in 2018.

참고문헌

  1. Elgellaie A, Ashcroft E, Larkin TA. Effects of thickness of muscle and subcutaneous fat on efficacy of gluteal intramuscular injection sites. Br J Nurs 2018;27:300-5. 
  2. Hopkins U, Arias CY. Large-volume IM injections: a review of best practices. Oncol Nurse Advis 2013;4:32-7. 
  3. Nakajima Y, Fujii T, Mukai K, Ishida A, Kato M, Takahashi M, Tsuda M, Hashiba N, Mori N, Yamanaka A, Ozaki N, Nakatani T. Anatomically safe sites for intramuscular injections: a cross-sectional study on young adults and cadavers with a focus on the thigh. Hum Vaccin Immunother 2020;16:189-96. 
  4. Nicoll LH, Hesby A. Intramuscular injection: an integrative research review and guideline for evidence-based practice. Appl Nurs Res 2002;15:149-62. 
  5. WHO calls for worldwide use of "smart" syringes [Internet]. Geneva: World Health Organization; 2015 [cited 2021 Oct 20]. Available from: https://www.who.int/news/item/23-02-2015-who-calls-for-worldwide-use-of-smart-syringes. 
  6. Zelman S. Notes on techniques of intramuscular injection. The avoidance of needless pain and morbidity. Am J Med Sci 1961;241:563-74. 
  7. Barry JM, Harsh V, Patil S. Are our intramuscular injections nerve-friendly? What are we missing? Simple techniques to prevent, recognize and manage nerve injection injuries. Int J Stud Res 2014;4:25-8. 
  8. Larkin TA, Ashcroft E, Elgellaie A, Hickey BA. Ventrogluteal versus dorsogluteal site selection: a cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome. Int J Nurs Stud 2017;71:1-7. 
  9. Larkin TA, Ashcroft E, Hickey BA, Elgellaie A. Influence of gender, BMI and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites. J Clin Nurs 2018;27:e242-50. 
  10. Mishra P, Stringer MD. Sciatic nerve injury from intramuscular injection: a persistent and global problem. Int J Clin Pract 2010;64:1573-9. 
  11. Zaybak A, Gunes UY, Tamsel S, Khorshid L, Eser I. Does obesity prevent the needle from reaching muscle in intramuscular injections? J Adv Nurs 2007;58:552-6. 
  12. Heo M, Faith MS, Pietrobelli A, Heymsfield SB. Percentage of body fat cutoffs by sex, age, and race-ethnicity in the US adult population from NHANES 1999-2004. Am J Clin Nutr 2012;95:594-602. 
  13. Holliday RM, Gupta V, Vibhute PG. Body mass index: a reliable predictor of subcutaneous fat thickness and needle length for ventral gluteal intramuscular injections. Am J Ther 2019;26:e72-8. 
  14. Jensen B, Moritoyo T, Kaufer-Horwitz M, Peine S, Norman K, Maisch MJ, Matsumoto A, Masui Y, Velazquez-Gonzalez A, Dominguez-Garcia J, Fonz-Enriquez E, Salgado-Moctezuma SG, Bosy-Westphal A. Ethnic differences in fat and muscle mass and their implication for interpretation of bioelectrical impedance vector analysis. Appl Physiol Nutr Metab 2019;44:619-26. 
  15. Moore KL, Dalley AF, Agur AMR. Lower limb. In: Moore KL, Dalley AF, Agur AMR, editors. Clinically Oriented Anatomy. 8th ed. Philadelphia: Wolters Kluwer; 2014. p.721-35. 
  16. Greenway K. Using the ventrologluteal site for intramuscular injection. Nurs Stand 2004;18:39-42. 
  17. Burbridge BE. Computed tomographic measurement of gluteal subcutaneous fat thickness in reference to failure of gluteal intramuscular injections. Can Assoc Radiol J 2007;58:72-5. 
  18. Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim SY, Yoo KH, Jung KS, Kim YK, Rhee CK. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis 2017;12:2465-75. 
  19. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, Kim BY, Kim YH, Kim WJ, Kim EM, Kim HS, Shin YA, Shin HJ, Lee KR, Lee KY, Lee SY, Lee SK, Lee JH, Lee CB, Chung S, Cho YH, Choi KM, Han JS, Yoo SJ. 2018 Korean Society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr 2019;28:40-5.