• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.1
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• pp.27-31
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• 2011

We report two cases of accidental overdoses of intramuscular midazolam used for a conscious sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The pedodontist prescribed midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 2 ml (2 mg) by verbal order to hygienist. The hygienist instead of the pedodontist wrote a prescription for midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 2 ml (10 mg). The inexperienced nurse gave an injection to his buttock as prescription. The child fell into a deep sedation. A 4-year-old boy with dental caries was scheduled for treatment under conscious sedation. The inexperienced pedodontist gave an injection to his buttock midazolam ($dormicum^{(R)}$ 15 mg / 3 ml) 3 ml (15 mg) instead of midazolam ($dormicum^{(R)}$ 5 mg / 5 ml) 3 ml (3 mg). The child fell into a deep sedation. Both cases had no complications, but the accidents happened as a result of the inexperienced dental staffs. The five times midazoalm instead of the intended doses was inadvertently given intramuscularly, fortunately caused no harm in our cases. However, the situations suggest that we should carefully check the dosage and review the correct procedures, even when using a drug that is considered to be familiar with most practitioners.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.486-494
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• 2019

Purpose: To investigate the effect of $Buzzy^{(R)}$ and $ShotBlocker^{(R)}$ on reducing pain induced by intramuscular penicillin injections in children. Methods: This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, $Buzzy^{(R)}=50$, $ShotBlocker^{(R)}=50$). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised. Results: The children in the control group had significantly higher pain scores during the penicillin injection than the children in the $ShotBlocker^{(R)}$ and $Buzzy^{(R)}$ groups. The children in the $Buzzy^{(R)}$ group had significantly less pain than the children in both the $ShotBlocker^{(R)}$ and control groups (p<.001). Conclusion: $Buzzy^{(R)}$ was more effective compared with $ShotBlocker^{(R)}$ in this study.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.124-131
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• 2021

Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.275-281
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• 2010

The lateral pterygoid muscle is one of the masticatory muscles basic to jaw function. Because of its deep location in the masticatory system, digital palpation of the muscle is usually difficult to perform and unreliable. Therefore, diagnosis of the myalgic disorders involving the lateral pterygoid muscle is a perplexing problem for clinicians. Local anesthetic injection can be a more effective method to examine the lateral pterygoid muscle for the purpose of discriminating the source of pain. Furthermore, immediate elimination of muscle pain facilitates stretching of the muscle in the full range. We report two cases of lateral pterygoid myalgia that were diagnosed and managed successfully through the use of intramuscular local anesthetic injection.

• Journal of Aquaculture
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• v.10 no.4
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• pp.439-447
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• 1997

A specific disease syndrome, which led to massive mortality on the Korean mandarin fish fingerling (Sinperca scherzeri) at Chongpyong Inland Fisheries Institute was atudied. The causetive agent isolated from the diseased fish was identified as Aeromonas hydrophila on the basis of biochemical and physiological characteristics. Infection experiments in the Korean mandarin fish fingerling, weighting 3-4 g with A. hydrophila were conducted by immersion, oral administration, intramuscular injection, and injection of the soluble extracellular products secreted from it. Motality rate was higher virulence in intramuscular injection group than other experimental groups. In injection group of the soluble extracellular products, all fish treated with high concentration ($8{\times}10^9$ cfu/ml) were repidly killed into 3-6 hrs. There results show that the Korea mandarin fish fingerling has high susceptibility to A. hydrophila.

• Journal of Pharmacopuncture
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• v.18 no.2
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• pp.76-85
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• 2015

Objectives: Radix Ginseng has been traditionally used as an adaptogen that acts on the adrenal cortex and stimulates or relaxes the nervous system to restore emotional and physical balance and to improve well-being in cases of degenerative disease and/or old age. Radix Ginseng has been used for a long time, but the safety of ginseng pharmacopuncture needs testing. This study was done to analyze the single-dose toxicity of water- soluble ginseng pharmacopuncture (GP) intramuscular injections in rats. Methods: All experiments were performed at Biotoxtech, an institution authorized to perform non clinical studies under the regulations of Good Laboratory Practice (GLP). Each group contained 10 Sprague-Dawley rats, 5 males and 5 females. GP was prepared in a sterile room at the Korean Pharmacopuncture Institute under regulations of Good Manufacturing Practice (GMP). GP dosages were 0.1, 0.5 and 1.0 mL for the experimental groups; normal saline was administered to the control group. The animals general condition was examined daily for 14 days, and the rats were weighed on the starting day and at 3, 7 and 14 days after administration of the pharmacopuncture. Hematological and biochemistry tests and autopsies were done to test the toxicological effect of GP after 14 days. This study was performed with approval from the Institutional Animal Ethics Committee of Biotextech. Results: No deaths were found in this single-dose toxicity test of intramuscular injections of GP, and no significant changes in the general conditions, body weights, hematological and biochemistry tests, and autopsies were observed. The local injection site showed no changes. Based on these results, the lethal dose was assumed to be over 1.0 mL/animal in both sexes. Conclusion: These results suggest that GP is relatively safe. Further studies, including a repeated toxicity test, are needed to provide more concrete evidence for the safety of GP.

• Journal of Pharmacopuncture
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• v.18 no.4
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• pp.51-58
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• 2015

Objectives: Bufonis venonum (BV) is the dried white secretions of the auricular and skin glands of the toads Bufo bufo gargarizans or Bufo melanosticus Schneider. This study was performed to evaluate the toxicity of intramuscularly-administered Bufonis venonum pharmacopuncture (BVP) and to calculate its approximate lethality through a single-dose test with Sprague-Dawley (SD) rats. Methods: Twenty male and 20 female 6-week-old SD rats were injected intramuscularly with BVP or normal saline. The animals were divided into four groups with five female and five male rats per group: the control group injected with normal saline at 0.5 mL/animal, the low-dosage group injected with 0.125 mL/animal of BVP, the medium-dosage group injected with 0.25 mL/animal of BVP and the high-dosage group injected with 0.5 mL/animal of BVP. All injections were in the left thighs of the rats. After administration, we conducted clinical observations everyday and body weight measurements on days 3, 7 and 14 after the injection. We also carried out hematology, serum biochemistry, and histological observations on day 15 after treatment. Results: No mortalities were observed in any experimental group. No significant changes in weight, hematology, serum biochemistry, and histological observations that could be attributed to the intramuscular injection of BVP were observed in any experimental group. Conclusion: Lethal dose of BVP administered via intramuscular injection in SD rats is over 0.5 mL/animal.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.415-420
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• 2013

This study was performed to examine the anesthetic and cardiopulmonary effects of medetomidine, midazolam and ketamine (MMK) combination in ten beagle dogs. Dogs were randomly allocated to two groups. Treatment group MMK-L received 0.015 mg/kg medetomidine followed by 0.3 mg/kg midazolam and 5 mg/kg ketamine by intramuscular injection. Treatment group MMK-H received 0.02 mg/kg medetomidine followed by 0.3 mg/kg midazolam and 5 mg/kg ketamine by intramuscular injection. Induction, anesthesia, sternal recumbency, standing, walking time, heart rate, arterial blood pressure, rectal temperature, respiratory rate and arterial blood gases were measured. Mean anesthesia time was significantly different between MMK-L group ($52.4{\pm}11.08$ minutes) and MMK-H group ($78.2{\pm}20.72$ minutes). Sedative scores and noxious stimuli were raised to the maximum value at 5 minutes after administration of the test dose and maintained until 40 minutes in both groups. In both groups, the heart rate significantly decreased after MMK administration. The blood pressures (MAP, SAP and DAP) increased after MMK administration but there were no significant differences in blood pressures between two groups. In conclusion, intramuscular administration of medetomidine followed by intramuscular injection of midazolam and ketamine in beagle dogs, leads immediate and sufficient anesthesia and proper doses of medetomidine for minimal adverse effects in intramuscular MMK combination will be 0.015 mg/kg in dogs.

• Archives of Pharmacal Research
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• v.24 no.6
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• pp.541-545
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• 2001

The evaluation of the anti-inflammatory analgesic and antipyretic activities of loxoprofen sodium given in intramuscular route was investigated as compared to oral application in rats and mice. The intramuscular $ED_{50}$ values of loxoprofen sodium in carrageenan edema and vascular permeability tests are 1.15 and 7.8 mg/kg, respectively, which represent more potent than in case of oral application. Its therapeutic effects in adjuvant arthritis were shown at 6 mg/kg l.m. and 3mg/kg p.o. Analgesic effect was shown to be more potent as given intramuscularly. Similar potency of antipyretic effects was shown in both administration routes. Considerably weak gastric damages were observed in intramuscular application.

• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.247-254
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• 2010

Purpose: To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements. Methods: The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT. Results: The average thickness of gluteal SCF was $15.92{\pm}4.08mm$ in males and $24.90{\pm}5.47mm$ in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients. Conclusion: The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.