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At least 199 records · Page 11Linked to original sources
PubMed2001

The effect of injection speed on the perception of intramuscular injection pain. A clinical update.

Injections are frequently administered by occupational health nurses in worksite health promotion programs. The purpose of this study was to examine the effect of varying injection speed on the perception of pain. Fifty workers were given intramuscular (i.m.) hepatitis B vaccine at injection speeds of 10 and 30 seconds per cubic centimeter (s/cc). The perception of pain was measured on a visual analogue scale and reported post-injection at three different time intervals. The results showed that no difference in pain was perceived by participants between the two injection speeds. Results also revealed that women consistently had higher mean pain scores than men and significantly more pain at the 0 hour measurement of the 10 s/cc injection. While the results of this study indicate no need to administer an i.m. injection slower than 10 s/cc, occupational health nurses will need to consider gender differences in pain perception when administering injections.

Adult↗
PubMed2002

Poly-L-glutamate, an anionic polymer, enhances transgene expression for plasmids delivered by intramuscular injection with in vivo electroporation.

Intramuscular (i.m.) injection of plasmids followed by electropermeabilization is an efficient process to deliver genes into skeletal myofibers that permits proteins to be produced and secreted at therapeutically relevant levels. To further improve skeletal muscle as a bioreactor, we identified a formulation that elevates transgene expression in myofibers after i.m. injection and electroporation. With secreted placental alkaline phosphate (SEAP) as reporter gene, plasmid formulated with poly-L-glutamate produced two- to eight-fold higher levels of SEAP in mouse serum than plasmid in saline. Various concentrations and molecular weights of poly-L-glutamate were similarly effective, but 6 mg/ml of 15-50 kDa poly-L-glutamate consistently yielded the highest expression levels. The poly-L-glutamate formulation was effective in two different muscle groups in mice at various plasmid doses for several transgenes, including an erythropoietin (EPO) gene, for which expression was elevated four- to 12-fold in comparison to animals that received EPO plasmid in saline. Transgene expression was localized to myofibers. Poly-L-glutamate may improve transgene expression in part by increasing plasmid retention in skeletal muscle. Poly-L-glutamate did not enhance gene transfer in the absence of electroporation. Therefore, the polymer is a novel formulation that specifically enhances the transfer and expression of genes delivered with electroporation.

Alkaline Phosphatase↗
PubMed1977

Quadriceps contracture as a result of multiple intramuscular injection.

Quadriceps contracture in children can result from multiple intramuscular injections. We describe here seven patients with this complication. These patients were unable to completely flex the involved knee. At surgery, extensive fibrosis of the quadriceps muscle was found. Lengthening of the scar and contracted muscle and tendon restored a good deal of flexion. If long-term antibiotic treatment is anticipated, the intravenous route should be employed if possible.

Child↗
PubMed1976

The effect on serum enzymes of intramuscular injections of digoxin, bumetanide, pentazocine and isotonic sodium chloride.

Intramuscular injections of digoxin, bumetanide, pentazocine or isotonic sodium chloride have been given to 39 patients. We followed the serum concentrations of creatine kinase (CK), aspartate aminotransferase (ASAT), lactate dehydrogenase (LDH) and LDH isoenzymes for 4 days. Ten patients receiving 500 mug digoxin showed a significant rise in CK, which lasted for 48 hours, and 6 of them had CK values exceeding the upper normal limit. Pentazocine in a dose of 30 mg given to 9 patients caused a significant rise in CK and LDH isoenzyme 1, but in no case did the level exceed the upper normal limit. No rise in ASAT or total LDH was found after digoxin and pentazocine injections. No changes in enzymes were discovered after bumetanide or isotonic sodium chloride. In the diagnostic evaluation of acute myocardial infarction, a moderate rise in CK must be assessed with caution when the patients have received i.m. injections of drugs with osmolarity and pH outside the physiological limits.

Aspartate Aminotransferases↗
PubMed1970

The uptake of tritiated hycanthone by male and female Schistosoma mansoni worms and distribution of the drug in plasma and whole blood of mice following a single intramuscular injection.

Mice infected with Schistosoma mansoni were given an intramuscular injection of a single 80 mg/kg dose of randomly tritiated hycanthone. The uptake of the drug in male and female worms, as well as its concentration in the red blood cells and plasma of the mice, was followed for a period of 24 hours.Blood and plasma drug levels reached maximum values within 30 minutes. During the postmedication period, plasma concentrations were consistently higher than red blood cell concentrations. At 2-6 hours, when blood levels were declining, peak uptake was reached in the female schistosome worms; the concentration in the female worm was 5 times higher than in the male worm. At 24 hours the schistosomes contained appreciably more drug than was present in the blood.

Animals↗
PubMed1987

Influence of solvent on the availability of testosterone propionate from oily, intramuscular injections in the rat.

The suggestion that the biological response to an oily intramuscular injection of testosterone ester is regulated by rapid accumulation of the steroid in body fat, followed by a slow release, has been tested by comparing the release rates of 14C-labelled testosterone propionate from different solvents following intramuscular injection into rats. Disappearance from the injection site was rectilinearly related to in-vitro partition coefficients, but elimination of radioactivity in urine and faeces was significantly longer, and the same for all four solvents. Testosterone and testosterone propionate were found in equal concentration in body fat, 2 and 3 days after injection, but their concentrations were too low to form an effective depot. It is suggested that the delay in release, and the independence of the delay on the nature of the solvent is a consequence of biliary recycling of testosterone.

Adipose Tissue↗
PubMed1975

Midtrimester abortion induced by serial intramuscular injections of 15(S)-15-methyl-prostaglandin E2 methyl ester.

Midtrimester abortion was successfully induced in 29 of 30 patients with serial intramuscular injections of 15(S)-15-methyl-prostaglandin E2 methyl ester (15-ME-PGE2). The mean abortion time was 9.52 hours; parous patients aborted somewhat faster (mean, 8.76 hours) than nulliparous patients (mean, 10.47 hours). Eight patients were monitored throughout the abortion procedure and uterine activity was calculated and analyzed. Uterine response to a single injection of 5 mug 15-ME-PGE2 was characterized by the rapid appearance of low-amplitude, high-frequency contractions accompanied by a rise in intrauterine baseline tonus. Uterine activity rose to a mean of 500 Montevideo Units within 40 minutes of the initial intramuscular injection of 15-ME-PGE2. The most frequently encountered side effect of intramuscular injections of 15-ME-PGE2 was temperature elevation of 2 degrees F. or higher, which occurred in 29 of 30 patients. Five patients complained of shaking and chills but only five patients had any gastrointestinal side effects. From this study it appeared that on a weight-for-weight basis 15-ME-PGE2 is at least 20 times more potent than 15-ME-PGE2alpha and 1,000 time more potent than the naturally occurring PGE2.

Abortifacient Agents↗
PubMed1990

Effects of intramuscular injections of folic acid on serum folates, haematological status and growth performance of growing-finishing pigs.

In a first trial, 48 piglets aged 5 weeks, grouped into 6 blocks of 8 pigs each, were used to determine the effect of intramuscular injections of folic acid on serum folates, haematological status, growth performance and carcass characteristics. Each block consisted of 2 pens of 4 pigs; in one pen, pigs received, by weekly intramuscular injections, an increasing volume of a solution containing 5 mg/ml folic acid, while in the other the animals were non-injected controls. The concentration of serum folates in treated pigs was 19% higher (P = 0.005) than in controls. There was no effect of treatment (P greater than or equal to 0.29) on haemoglobin and haematocrit. During the starting period, (5-11 weeks) average daily gain was not influenced by folic acid injections but feed intake and feed conversion were decreased (P = 0.07 and P = 0.05 respectively). No effect of folic acid (P greater than or equal to 0.23) was noted from 11-23 weeks of age, suggesting that the supplement was suboptimal during the growing-finishing period. In a second trial, 72 piglets aged 9 weeks were assigned to 6 blocks of 12 animals each. The following treatments were randomly distributed in each block according to a 2 x 3 factorial design: level of feeding (restricted vs ad libitum) and weekly intramuscular injections of increasing volume of solutions containing either 0, 15 or 30 mg/ml of folic acid. The variables studied were the same as in Trial 1. Concentrations of serum folates varied quadratically (P = 0.0001) with the dose injected, a plateau being attained with injections of 15 mg/ml. There was no effect of treatment (P = 0.043) on haemoglobin and haematocrit. During the growing period (9-15 weeks), no effect (P greater than or equal to 0.72) of folic acid was noted on growth performance. However, during the finishing period (15-21 weeks), folic acid given at a dose of 30 mg/ml decreased (P = 0.006) feed intake while no effect (P greater than or equal to 0.13) of the vitamin supplementation was noted on average daily gain and feed conversion. In both trials, there was no effect (P greater than or equal to 0.21) of any treatments on carcass characteristics. These results indicate that a supplement of folic acid administered by intramuscular injections was effective in increasing concentration of serum folates of starting or growing-finishing pigs. This supplement may be associated with a decrease in feed intake.

Animal Feed↗
PubMed1976

Termination of midtrimester pregnancy by serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha.

Midtrimester abortion was successfully induced in 117 of 120 patients with serial intramuscular injections of 15(S)-15-methyl-prostaglandin F2alpha (15-me-PGF2alpha). The mean abortion time was 14.12 hours, and parous patients aborted in a mean of 12.85 hours-significantly faster than nulliparous patients who aborted in a mean of 15.24 hours. Ninety-four per cent of the 117 successfully induced abortions occurred in less than 24 hours and 46 per cent in less than 12 hours. Uterine activity was monitored and analyzed in nine patients. Uterine response to a single intramuscular injection of 100 mug of 15-me-PGF2alpha was characterized by the appearance of low-amplitude, high frequency contractions and a rapid increase in baseline intrauterine tonus. A high level of uterine activity, 900 Montevideo Units, was observed within 30 minutes of the first intramuscular injection of 15-me-PGF2alpha. This activity was not maintained and decreased by approximately 30 per cent at the time of the second injection at 1 hour. It was not until 6 hours of 15-me-PGF2alpha therapy that activity stabilized at approximately 500 Montevideo Units. Even though all patients were premedicated with antiemetic and antidiarrhea agents, 68 of 120 patients experienced gastrointestinal side effects related to the 15-me-PGF2alpha administration. Vomiting was the most prevalent side effect, occuring in 65 patients, but the episodes were not severe, were well tolerated by the patients and did not necessitate the termination of prostaglandin administration in any of the patients. In this study abortion was successfully induced between weeks 9 to 27 of gestation. It was observed that patients with gestations of 16 weeks or less aborted significantly faster than patients with gestations of 17 weeks or more, which indicates that this method is highly effective in the induction of abortion within the "gray zone", 12 to 16 weeks of gestation.

Abortifacient Agents↗
PubMed1997

Expression of biologically active human insulin-like growth factor-I following intramuscular injection of a formulated plasmid in rats.

Recent evidence has shown that insulin-like growth factor-I (IGF-I) plays an important role in the development, maintenance, and regeneration of peripheral nerves and skeletal muscle. IGF-I offers the potential to treat neuromuscular diseases in humans. We have developed a nonviral gene therapy method to express and produce localized and sustained therapeutic levels of IGF-I within target muscles by intramuscular injection of formulated plasmids. The purpose of the present study was to demonstrate that intramuscular injection of a plasmid encoding human IGF-I (hIGF-I) and engineered to restrict expression to skeletal muscle produces sustained local concentrations of biologically active hIGF-I. Normal rats received a single intramuscular injection of plasmids formulated as a complex with polyvinylpyrrolidone (PVP). Results show that hIGF-I mRNA and hIGF-I protein were detectable in the injected muscles for the duration of the study (28 days), whereas the hIGF-I protein was not detected in blood. Biological activity of hIGF-I was determined by immunodetection of a nerve-specific growth-associated protein, GAP-43, an indicator of motor neuron sprouting. Placement of human growth hormone (hGH) 3' untranslated region enhanced GAP-43 staining, probably due to improved secretion of hIGF-I. Enhanced immunoreactivity of GAP-43 was observed in muscles injected with the formulated hIGF-I plasmid when compared to controls. These results demonstrate that intramuscular injection of hIGF-I plasmid formulated as a complex with PVP produces a localized and sustained level of biologically active hIGF-I.

Animals↗
PubMed1997

Pharmacokinetics of isepamicin following a single administration by intravenous infusion or intramuscular injections.

The pharmacokinetics of isepamicin following administration of a 1-g dose were evaluated for 18 healthy male volunteers between the ages of 26 and 38. In a randomized crossover fashion, each volunteer received doses of isepamicin by a 30-min intravenous infusion and as an intramuscular injection. Blood samples were collected at specified times after dosing and assayed for isepamicin by a validated radioimmunoassay method. The individual plasma concentration-time curves were analyzed by noncompartmental methods. In general, the pharmacokinetics after intravenous infusion and intramuscular injection were similar. As expected, the maximum concentration of isepamicin in serum following intramuscular injection (37.2 microg/ml) was lower than the observed concentration at the end of infusion (66.7 microg/ml). The areas under the concentration-time curves from 0 h to infinity following intramuscular and intravenous administration were 164.8 and 154.5 microg x hr/ml, respectively, indicating complete absorption following intramuscular administration. The respective mean terminal-phase half-life (t1/2) values were 2.6 and 3.6 h. Although t1/2 was slightly longer following intravenous infusion, the small difference in the observed t1/2 values was not considered to be clinically significant. Total body clearances following intramuscular injection and intravenous infusion were 1.3 and 1.4 ml/min/kg, respectively, which were similar to renal serum creatinine clearances in healthy volunteers (> 1.14 ml/min/kg). The drug was safe and well tolerated. The results of the present study clearly show complete absorption of isepamicin following intramuscular administration. The similarity in the pharmacokinetics after intravenous infusion and intramuscular dosing would permit interchangeable administration of isepamicin by either route without compromising clinical efficacy.

Adult↗
PubMed2002

Intramuscular injection angle: evidence for practice?

This article presents the findings of a search for evidence to support the 45-60 degree angle of insertion for intramuscular injection of vaccine which is recommended in New Zealand. With the objective of discovering the evidence base for an intramuscular injection angle which differs from that recommended by the World Health Organisation and the accepted practice experienced by the author in the UK, Canada, Malawi and the USA, a comprehensive library and internet literature search was undertaken. As well, information was sought by personal correspondence and contact with a range of immunisation specialists. Both the literature specifically on needle angle and that which includes needle angle within a wider investigation of technique is included. Overwhelmingly the evidence supports a 90 degree angle of needle insertion for intramuscular injection as being that most effective in terms of patient comfort, safety and efficacy of vaccine.

Clinical Nursing Research↗
PubMedDate not supplied

[Criteria used by nurses in choosing the site for intramuscular injections: custom or scientific evidence?].

The nursing literature of the last 20 years recommends the ventrogluteal site how the best site for intramuscular injections Beecroft, Redick, 1990, but, the few studies done with the aim to discover which is the most frequently used site report that the dorsogluteal site is the one preferred from nurses Farley, Joyce, Long et al., 1996. The propose of this descriptive study is to understand which are the criteria used by nurses when they have to decide which site choose for administering an intramuscular injection. 167 Italian nurses, from the province of Reggio Emilia, that answered at an anonymous questionnaire, compose the sample of this study. The study's outcomes demonstrate that the most frequently site used from the nurses is the dorsogluteal. The most frequently principles that support this choice are the easier access, the large muscle's bulk, the lower sensibility at the pain and the request of the patient. These reasons suggest that the nurses are guided, in choose the site for administering an intramuscular injection, much more by the customs than the evidence.

Adult↗
PubMed2005

The deltoid intramuscular injection site in the adult. Current practice among general practitioners and practice nurses.

A survey of 50 general practitioners and 50 practice nurses reviewed current practice in relation to intramuscular injections in the deltoid region of adults. The great majority of practitioners used the site for the intramuscular injection of vaccines and a wide range of other medications. The injection techniques employed by the two groups were similar. The great majority of respondents used either the middle one third or the upper half of the muscle. A significant minority of both groups used inappropriate depths of injection. Awareness of the structures which are at risk from injections in the region was poor in both groups. There is an urgent need to establish reliable protocols for the administration of safe, effective intramuscular injections at the deltoid site and to train practitioners in their use.

Humans↗
PubMed2004

Preventing sciatic nerve injury from intramuscular injections: literature review.

BACKGROUND: Injury to the sciatic nerve (SN) is a serious complication of intramuscular injection. AIM: The purpose of this paper was to identify factors associated with such iatrogenic injury in adults and measures that nurses may take to prevent it. METHOD: A review of the English language literature was undertaken to identify applicable research studies and determine the information that currently is being disseminated on relevant injection procedure. Legal databases were also searched for pertinent court decisions. DISCUSSION: The evidence is that injury to the SN is associated with use of the dorsogluteal (DG) site for injection. The choice of site for injection must be based on good clinical judgment, using the best evidence available and individualized assessment of the client. There is wide agreement in the literature that the ventrogluteal site is preferable. If the DG site is chosen, the nurse must have a full appreciation of the anatomy of the site and proximate anatomic structures, be able to accurately identify anatomic landmarks and site boundaries, and administer the injection with meticulous technique. Not only may SN injury resulting from erroneous injection cause client discomfort, morbidity and lasting disability, but it also provides the basis for nursing negligence suits. CONCLUSION: The research base for intramuscular injection is limited. Studies on various aspects of the procedure need to be carried out to provide support for clinical guidelines.

Buttocks↗