• Journal of Korean Biological Nursing Science
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• v.19 no.1
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• pp.11-17
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• 2017

Purpose: To determine the effects of neck and back touch on Ultrasonic Vocalization (UV) and the Rat Grimace Scale (RGS) in rats touched by the human hand as an intervention for reducing pain and anxiety associated with intramuscular injections. Methods: This study was a randomized, controlled, pre-test/post-test design study. Twenty male Sprague-Dawley rats were assigned to either the experimental or control groups (n= 10 rats/group). The experimental group was touched in a manner similar to massaging the rat's neck and back twice a day for one week. The two groups received two intramuscular injections. The 22kHz and 50kHz UV and the RGS scores were measured before and after each intramuscular injection. Results: The 22kHz UV and RGS score were significantly higher in the control group than in the experimental group when the first intramuscular injection was administered; whereas, no difference between the experimental and the control groups were observed when the second intramuscular injection was administered. There was no statistical difference in the 50kHz UV between the two groups when the first and second injections were administered. Conclusion: This study found that touching was an effective intervention method to reduce negative emotions and pain in rats receiving their first intramuscular injection.

• 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.

• Journal of Pharmaceutical Investigation
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• v.29 no.1
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• pp.67-72
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• 1999

A bioequivalence study of the $Kerola^{\circledR}$ intramuscular injections (Dongkwang Pharmaceutical Co., Korea) to the $Tarasyn^{\circledR}$ intramuscular injections (Roche Co., Korea), formulations of ketorolac tromethamine (KTR), was conducted. Sixteen healthy Korean male subjects were received each formulation at the dose of 30 mg as KTR in a $2{\times}2$ crossover study. There was an one-week washout period between the doses. Plasma concentrations of KTR were monitored by a HPLC method. AUC was calculated by the linear trapezoidal method. $C_{max}$ and $T_{max}$ were compiled from the plasma drug concentration-time data. Analysis of variance (ANOVA) revealed that there are no differences in AUC, $C_{max}$ and $T_{max}$ between the formulations. The differences between the formulations in these parameters were all far less than 20% (i.e., 3.65, 2.59 and 4.35% for AUC, $C_{max}$ and $T_{max}$ respectively). Minimum detectable differences (%) at ${\alpha}=0.1$ and $1-{\beta}=0.8$ were 12.87, 13.44, 20.62%, for AUC, $C_{max}$ and $T_{max}$, respectively. The 90% confidence intervals for these parameters were also within 20%. These results satisfy the bioequivalence criteria of the Korea Food and Drug Administration (KFDA) guidelines (No. 1998-86). Therefore, these results indicate that the two formulations of KTR are bioequivalent.

• Korean Journal of Acupuncture
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• v.38 no.4
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• pp.250-266
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• 2021

Objectives : This study was conducted to suggest new alternative methods to improve pharmacopuncture and Korean medicine research by analyzing the injection route, pharmacological effect, and status studies of Chinese herbal injections. Methods : 130 types of marketed and licensed Chinese herbal injection were searched from National Medical Products Administration (NMPA) of China. CNKI, PubMed, EMBASE, and the 2020 edition of the Chinese Pharmacopoeia were used to collect additional information. 'Herbal injection' and 'Chinese herbal injection' were used as keywords. All data were collected mainly on the treatment of Chinese herbal injection. But data which were not related to the relevant research or Chinese herbal injection were excluded. Results : Intramuscular injection accounted for more than half of the single injection route (51%). Acupoint and intramuscular injections accounted for 55% of dual injection routes. Acupoint, intravenous, and intramuscular injections accounted for the largest proportion (76%) of the multiple routes of injections. As for the pharmacological effect, injection for cardiovascular diseases accounted for 29%. About the number of raw herbal materials, single herbal material was the most common. Twelve intervention studies all tested intravenous injections, and half of them investigated cardiocerebrovascular diseases. All were given by intravenous injection. In the side effect section, the most common symptoms were nausea and vomiting. Conclusions : Through the results, it is expected to be used for research and development of new pharmacopuncture and herbal medicine.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.137-143
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• 1998

Intramuscular injection(IM) into the gluteal muscles is a common route of medication, but may lead to complications. A retrospective review of 32 patients who required surgical treatment for local complications of buttock injections in children was made at the Taegu Fatima Hospital during a seven-year nine-month period (March 1990 to December 1997). Local complications included acute inflammation, cellulitis and abscess(71.9 %), and fat necrosis(21.9 %), and injection granuloma(6.2 %). Over the half of injections were on the upper and outer quadrant of the buttock, but the other 43.7 % were in the upper and inner or lower and outer quadrant which are considered unsuitable sites for intramuscular injection. The majority of complications developed within fat tissue(90.6 %) rather than within muscle(9.4 %). Two-thirds of the patients were under 2 years of age, this suggests that it is technically difficult to accurately administer IM injections in small children because muscle mass is smaller compared to subcutaneous. In addition subcutaneous fat is more susceptible to chemical irritation. Staph. aureus was the predominant organism, isolated in 84.6 % of the patients with abscesses. Treatment consisted of needle aspiration, incision and drainage, curettage, or surgical excision. In conclusion, the major factor that contributes to complications following IM of the buttock appears to be the inadvertent intrafat rather than of IM injection. Accurate injection into the muscles based on a knowledge of pelvic anatomy as well as the potential complications is necessary to prevent complications.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.2
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• pp.119-122
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• 2007

Paraquat poisoning is a fatal type of herbicide intoxication. It is characterized by multi-organ failure and pulmonary fibrosis with respiratory failure. Intravenous and intramuscular injection of paraquat is rarely described. However, We encountered two fatal cases of acute poisoning caused by paraquat injection. Two patients were admitted to our emergency unit after intravenous and intramuscular injection of 23.8% paraquat (about 476 mg of paraquat). A 37-year-old man diluted 2 ml of 23.8% paraquat solution with 1 ml of normal saline and injected it both intravenously into his left antecubital fossa and intramuscularly into his abdomen in a suicide attempt. He died 5 days later from respiratory failure and acute renal failure. A 92-year-old man was injected intravenously into his right antecubital fossa by his grandson with 2 ml of 23.8% paraquat solution diluted with 1 ml of normal saline. He died 2 days later from early circulatory collapse and multi-organ failure (metabolic acidosis, acute renal failure, coagulopathy). Intravenous and intramuscular injection with a small quantity of paraquat resulted in fatal toxicity in our patients.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.69-73
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• 1998

Background: The postoperative pain in children and adolescents is most commonly managed by intramuscular injections of NSAIDs or opioids. This approach may result in fluctuating plasma drug levels and cycles of pain, comfort, and sedation. Patient-controlled analgesia(PCA) is a method of analgesia administration that consists of a computer-driven pump with a button that the patient may press to administer a small dose of analgesic drug. Materials & Methods: Forty ASA physical status 1 or 2 children and adolescents were divided into two groups. In the PRN group, patients received intramuscularly diclofenac(Valentac$^{(R)}$) on a p.r.n. basis. The PCA group patients received a mixture of nalbuphine and ketorolac by WalkMed$^{(R)}$PCA infusor. Analgesic efficacy was evaluated with NRS(numerical rating scale) and Faces Pain Rating Scale. The side effects were evaluated. Results: The patients of PCA group had less pain than those of PRN group. Complications were similar in both group. Conclusions: PCA with nalbuphine and ketorolac is a safe and effective methods of pain relief in children and adolescents after surgery, and is better accepted than intramuscular injections.

• 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.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.249-252
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• 2012

Nicolau syndrome is a rare complication of intramuscular injection consisting of ischemic necrosis of skin, soft tissue, and muscular tissue that arises locoregionally. The characteristic pattern is pain around the injection site, developing into erythema, a livedoid dermatitis patch, and necrosis of the skin, subcutaneous fat, and muscle tissue. Three patients were injected with drugs (diclofenac sodium, ketoprofen, meperidine) for pain relief. Three patients complained of pain, and a skin lesion was observed, after which necrosis developed on their buttocks. Each patient underwent debridement and coverage. The wound healed uneventfully. We report three cases of Nicolau syndrome in the buttocks following diclofenac intramuscular injection.

• Journal of Korean Academy of Nursing
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• v.18 no.3
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• pp.257-268
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• 1988

The purpose of this study was to compare the effect of the Z-track intramuscular injection technique with the effect of the stand and intramuscular injection technique on the severity of discomfort and leasions at the injection site. The subjects of the study were 20 patients with only early tuber culosis excluding another abnormalities (a akin rash, allergy to topical use of alcohol, jaundice, edema, neurosensory abnormality, coagulation defects, obesity and thin). Data collection was done from Feb. 1 to March 15, 1988 by means of Korean Pain Measurement Tool, Visual Analogue Scale, and Objective measures of injection site lesions. The results of this study were as follows ; 1) Hypothesis 1 ; “The severity of subject discomfort is less following administration of the Z-track intramuscular injection technique than following administra tion injection technique.” was not sopported 2) Hypothesis 2 ; “The degress of severity subject discomfort is less following administration of the Z-track intramuscular injection technique than following administra tion of the standard intramuscular injection technique.” was not supported. 3) Hypothesis 3 ; “The severity of injection site lesions is less following administra tion of the Z-track intramuscular injection technique than following administration of the standard intramuscular injection techniques.” was not supported. 4) The terms that were selected included factor II (mild-moderate pain) of Ratio Scale Measuring Pain using Korean Pain Terms. In conclusion ; it was found that there was not a difference from the severity of subject discomfort between two groups, but the degress of severity of subject discomfort about following administration of the Z-t-rack intramuscular injection was tended to be declined. Therefore further studies suggest that the Z-track intramuscular injection technique can decrease the severity of discomfort in persons receiving frequently intramuscular injections. First of all, it is necessery to be developed an effective tool of discomfort measurement for the intramuscular injection in Korean.