REDUCING THE PAIN ASSOCIATED WITH INTRAMUSCULAR INJECTION

Öz

Injections are among the most frequently used medical procedures. The administration of intramuscular injections is a responsibility of the professional nurse. Giving an injection safely requires knowledge of anatomy, physiology, pharmacology, psychology, and communication skills and practical expertise. Intramuscular injections cause pain and associated anxiety for patients. Injections-related pain can lead to life-long phobia, and may discourage a patient from accessing needed care. Good injection technique, appropriate patient information and a calm and confident nurse will help to reduce anxiety. There are different techniques for reducing the pain associated with intramuscular injection. Interventions for reducing pain due to injection would be inexpensive, noninvasive, and rapidly applied. Nurses should applied pain reducing techniques for the administration of intramuscular injections. In this article has been explained the basic principle and techniques for reducing the pain due to intramuscular injection

Anahtar Kelimeler

• pain,pain management,intramuscular injection,article

KAS İÇİ ENJEKSİYONA BAĞLI AĞRIYI AZALTMA

Öz

Enjeksiyonlar en sık kullanılan tıbbi işlemlerdendir. Kas içi enjeksiyonların uygulanması profesyonel hemşirenin sorumluluğundadır. Bir enjeksiyonu güvenli şekilde uygulamak anatomi, fizyoloji, farmakoloji, psikoloji bilgisi ile iletişim becerilerini ve uygulamada uzmanlığı gerektirir. Kas içi enjeksiyonlar hastalarda korkuya ve anksiyeteye neden olur. Enjeksiyona ilişkin korku, bir hastanın gereksinilen bakımı almak için başvurmasını engelleyebilir. İyi bir enjeksiyon tekniği, hastanın uygun biçimde bilgilendirilmesi, sakin ve kendine güvenen bir hemşire hastanın anksiyetesini azaltmaya yardım edecektir. Kas içi enjeksiyona bağlı ağrıyı azaltmaya yönelik çeşitli yöntemler vardır. Enjeksiyona bağlı ağrıyı azaltma yöntemleri pahalı ve invaziv olmamalı ve hızlıca uygulanmalıdır. Hemşireler kas içi enjeksiyona bağlı ağrıyı azaltmaya yönelik yöntemleri uygulamalıdır. Bu makalede kas içi enjeksiyona bağlı ağrıyı azaltmaya yönelik temel ilkeler ve yöntemler anlatılmıştır

Anahtar Kelimeler

• ağrı,ağrı yönetimi,derleme,kas içi enjeksiyon

Kaynakça

1. Ağaç E, Güneş ÜY. Effect on pain of changing the needle prior to administering medicine intramuscularly: a randomized controlled trial. Journal of Advanced Nursing, 2011; 67: 563-568.
2. Alavi NM. Effectiveness of acupressure to reduce pain in intramuscular injections, Acute Pain, 2007: 9: 201-205.
3. Aslan FE. Ağrıya ilişkin kavramlar. Ağrı, doğası ve kontrolü. Avrupa Tıp Kitapçılık Ltd Şti, İstanbul, 2006: 46-50.
4. Barnhill BJ, Holbert MD, Jackson NM, et al. Using pressure to decrease the pain of intramuscular injections, Journal of Pain and Symptom Management, 1996: 12(1):52-57.
5. Brazeau GA, Cooper B, Svetic K, et al. Current perspectives on pain upon injection of drugs, Journal of Pharmaceutical Sciences, 1998: 87(6): 667-677.
6. Cassidy KL, Reid GJ, McGrath PJ, et al. A randomized double-blind, placebo-controlled trial of the EMLA patch for the reduction of pain associated with intramuscular injection in four to six-years-old children, Acta Peadiatr, 2001: 90:1329-1336.
7. Chung JWY, Ng WMY, Wong TS. An experimental study on the use of manual pressure to reduce pain in intramuscular injections, Journal of Clinical Nursing, 2002: 11: 457-461.
8. Cimili C. Cerrahide anksiyete, Klinik Psikiyatri, 2001; 4: 18-186.

9. Cobb EJ, Cohen LL. A randomized conrolled trial of the shotblocker for children’s immunization distress, Clin J Pain, 2009: 25(9): 790-796.
10. Drago LA, Singh SB, Douglass-Bright A, et al. Efficacy of shotblocker in reducing pediatric pain associated with intramuscular injections, American Journal of Emergency Medicine, 2009: 27: 536-543.
11. Farhadi A, Esmailzadeh M. Effect of local cold on intensity of pain due to Penicilin Benzathin intramuscular injection, International Journal of Medicine and Medical Sciences, 2011: 3(11): 343-345.
12. Foster R, Eberhart T, Zuk J, et al. Is the shotblocker effective in reducing immunization pain? Research News, 2005; 12: 1-2.
13. Guevarra MAD (2005). Efficacy of shotblocker® in reducing pain associated with intramuscular injections in pre-school children, http://www.bionix.com/Pages/MedStudy1.html
14. Gundrum T, Sherman C, Ruhlman S (2005). Assessment of discomfort with usual immunization practice compared to the use of usual practice and shotblocker®. http://www.bionix.com/Pages/MedStudy2.html
15. Hasanpour M, Tootoonchi M, Aein F, et al. The effects of two non-pharmacologic pain management methods for intramuscular injection pain in children, Acute Pain, 2006; 8:7-12.
16. Hay J. Complications at site of injection of depot neuroleptics, BMJ, 1995: 311(7002): 421.
17. Hemsworth S. Intramuscular (IM) injection technique. Paediatric Nursing, 2000; 12: 17-20.
18. Hunt CW. Which site is best for an I.M. injection? Nursing, 2008; 18: 62.
19. Himelstein BP, Cnaan A, Blackall CS, et al. Topical application of lidocaine-prilocaine (EMLA) cream reduces the pain of intramuscular infiltration of saline. Journal of Pediatrics, 1996: 129(5): 718-721.
20. Hogan ME, Kikuta A, Taddio A. A systematic review of measures for reducing injection pain during adult immunization, Vaccine, 2010: 28: 1514-1521.
21. Kanika KH, Rani, SP. Effect of massage on pain perception after administration of intramuscular injection among adult patients, Nursing and Midwifery Research Journal, 2011: 7(3): 130-138.
22. Kevin LT, Fallon LF, Olumo AA. Deltoid muscle atrophy secondary to hepatitis B injection? a case report, Journal of Controversial Medical Claims, 2004: 11(1):9-12.
23. Kusumadevi MS, Dayananda G, Shivakumar V, et al. The perception of intramuscular injection pain in men vs women, Biomedical Research, 2011: 22(1): 107-110.
24. Lynn K. Needle phobies: stuck on not getting stuck. MLO (Medical Laboratory Observer) 2010; September: 48.
25. Maistoroviç M, Veerkamp JS. Relationship between needle phobia and dental anxiety. J Dent.Child, 2004: 71(3): 201-205.
26. Malkin B. Are techniques used for inramuscular injection based on research evidence? Nursing Times, 2008: 104(50/51): 48-51.
27. Mawhorter S, Daugherty L, Ford A, et al. Topical vapocoolant quickly and effectively reduces vaccine- associated pain: results od a randomized, single-blinded, placebo-controlled study. J Travel Med, 2004: 11(5): 267-272.
28. Mennuti-Washburn JE. Gate control theory and its application in a physical intervention to reduce children’s pain during immunization injections (dissertation). Georgiga State University, Department of Psychology Theses. 2007.
29. McQueen M. Assessing intramuscular injection: technique, site and pain perception. The Degree of Master of Science in Nursing a Thesis. Alberta University, Canada. 1990.
30. Mitchell JR, Whitney FW. The effect of injection speed on the perception of intramuscular injection pain, AAOHN, 2001: 49(6):286-292.
31. Mitchell JR. The effect of injection speed on the perception of intramuscular injection pain. The Degree of Master of Science in Nursing a Thesis. School of Nursing and Graduate School of The University of Wyoming. 1998.
32. Nicoll LH, Hesby A. Intramuscular injection: an integrative research review and guideline for evidence- based practise, Applied Nursing Research, 2002: 16(2):149-162.
33. Özdemir L, Pιnarcı E, Akay BN ve ark. Effect of methylprednisolone injection speed on the perception of intramuscular injection pain, Pain Management Nursing, 2010; 1-8.
34. Özer S, Akyürek B, Başbakkal Z. Hemşirelerin ağrı ile ilgili bilgi, davranış ve klinik karar verme yeteneklerinin incelenmesi, Ağrı, 2006: 18(4):36-43.
35. Pamukçu G. Erişkinlerde intramüsküler yolla tetanoz aşısı enjeksiyonu öncesinde buz uygulamasının enjeksiyonun sebep olduğu ağrıya etkisi. Gazi Üniversitesi Acil Tıp Anabilim Dalı Uzmanlık Tezi. Ankara: 2008.
36. Rock D. Does drawing up technique influence patients’ perception of pain at the injection site? Australian and New Zealand Journal of Mental Health Nursing, 2000; 9:147-151.
37. Rodger MA, King L. Drawing up and administering intramuscular injections: a review of the literature, Journal of Advanced Nursing, 2000; 31(3):574-582.
38. Rubin TK, Gandevia SC, Henderson LA, et al. Effects of intramuscular anesthesia on the expression of primary and referred pain induced by intramuscular injection of hypertonic saline, The Journal of Pain, 2009: 10(8): 829-835.
39. Shah VS, Taddio A, Hancock R, et al. Topical amethocaine gel 4% for intramuscular injection in term neonates: a double-blind, placebo-controlled, randomized trial. Clinical Therapeutics, 2008: 30(1): 166-174.
40. Shatsky Do M. Evidence for the use of intramuscular injections in outpatient practice, American Family Physician, 2009: 79(4):297-300.
41. Small SP. Preventing sciatic nerve injury from intramuscular injections: literature review, Journal of Advanced Nursing, 2004: 47(3):287-296.
42. Stanfield JA. Comparative study of ventrogluteal and dorsogluteal sites on pain following intramuscular injection. The Degree of Master of Science in Nursing a Thesis. Medical College of Georgia, U.S.A. 1992.
43. Sajedi F, Kashaninia Z, Rahgozar M and Radrazm L. The efficacy of oral glucose for relieving pain following intramuscular injection in term neonates, Acta Medica Iranica, 2006: 44(5): 315- 322.
44. Susilawati S, Arhana BNP, Subanada IB. Effectiveness of painaway on hepatitis B intramuscular injection in term neonates: a randomized controlled trial, Paediatrica Indonesiana, 2010: 50(4): 214-219.
45. Taddio A, Ilersich AL, Ipp M, Kikuta A, Shah V. Physical interventions and injecton techniques for reducing injection pain during routine childhood immunizations: systematic review of randomized controlled trials and quas-randomized controlled trials. Clinical Therapeutics, 2009; 31(Suppl B):48-76.
46. Templeton HC, McCoy T. Are we on the same page? : a comparison of intramuscular injection explanations in nursing fundamental texts, MEDSURG Nursing, 2008: 17(4): 237-240.
47. Treadwell T. Intramuscular injection site injuries masquerading as ulcers, Wounds, 2003: 15(9):302-312.
48. Tuğrul E. İntramüsküler Yolla İlaç Uygulamasında İlacın Verildiği Bölgenin ve Veriliş Hızının Ağrıya Etkisi, Ege Üniversitesi Sağlık Bilimleri Enstitüsü Yüksek Lisans Tezi. İzmir: 2011.
49. Uzelli D. Yenidoğana uygulanan intramüsküler enjeksiyonda sukroz solusyonunun ağrı üzerine etkisinin incelenmesi. Yüksek Lisans Tezi. Ege Üniversitesi Sağlık Bilimleri Enstitüsü. İzmir: 2011.
50. Walding MF. Pain, anxiety and powerlessness. Journal of Advanced Nursing, 1991: 16: 388-397.
51. Wynaden D, Landsborough I, McGowan S, et al. Best practice guidelines for the administration of intramuscular injections in the mental health setting. International Journal Mental Health Nursing 2006: 15:195-200.
52. Workman B. Safe injection techniques, Nursing Standart, 1999; 13(39): 47-53.