Effect on pain of changing the needle prior to administering medicine intramuscularly: a randomized controlled trial

Ağaç, Emine; Güneş, Ülkü Yapucu

doi:10.1111/j.1365-2648.2010.05513.x

Cited by 38 publications

(30 citation statements)

References 19 publications

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“…The two‐needle technique has been found to have a large effect on pain relief. According to Rock () and Ağaç and Güneş (), the results support the implementation of the two‐needle technique in the application of IM injections. The use of the two‐needle technique was one of the effective methods assessed in this SR. Other studies have suggested that the two‐needle technique (a needle for preparation, another one for administration) can be used to reduce patient discomfort (Nicoll & Hesby, ; Rodger & King, ; Wynaden et al, ).…”

Section: Discussionmentioning

confidence: 59%

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Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Zeyrek

Takmak

Kurban

et al. 2019

Journal of Advanced Nursing

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Aims To assess the effectiveness of physical‐procedural interventions in reducing pain during intramuscular injections. Design Systematic review and meta‐analysis. Method English keywords were used to search databases [MEDLINE (OVID, Ebsco), SCOPUS, Science Direct, COCHRANE and the reference lists from retrieved articles] from their inception to November 2017 and randomized and quasi‐experimental trials were selected based on inclusion and exclusion criteria. The standardized mean difference and random effects model were used. Results From 2,318 articles, 15 articles (1996–2017) met the criteria for the meta‐analysis. Physical‐procedural interventions described in the articles were included in this systematic review. The overall standardized mean difference was 0.595 (95% confidence interval (CI) = 0.417–0.773), indicating a moderate effect on pain levels. Generally, these interventions (two‐needle technique, acupressure, manual pressure, ShotBlocker, Z‐technique, air‐lock technique, injection site postinjection massage, and speed of injection) have been found to moderately reduce pain. Conclusion It seems difficult to conclude that a single intervention reduces pain in adults. However, we can state that the most effective interventions for reducing pain during intramuscular injections in adults involve the ventrogluteal site, the Z‐technique, and manual pressure. Impact The systematic review will provide guidance to clinicians, staff, and educator nurses and future studies. The systematic review will help nurses and educators apply techniques based on evidence in any setting. The systematic review will guide well‐designed and well‐reported studies to contribute to the accumulation of evidence in nursing research.

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Section: Discussionmentioning

confidence: 59%

“…Five studies had a low level of bias related to blinding of outcome assessment (Ağaç & Yapucu Güneş, ; Alavi, ; Kara & Yapucu Güneş, ; Yilmaz, Dikmen, et al, ; Yilmaz, Khorshid, et al, ). The blinding was unclear in two studies (Chung et al, ; Rock, ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Zeyrek

Takmak

Kurban

et al. 2019

Journal of Advanced Nursing

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“…40 Using separate needles for drawing up and injection significantly reduced pain intensity of needle insertion. 41 A sharper needle reduces the force required to puncture the skin. 38 This activates fewer nerve fibers, reducing temporal stimulation of afferent nociceptor fibers and thus minimizing pain.…”

Section: Use Fresh Needles: Repeated Needle Use Dulls the Tip And Incmentioning

confidence: 99%

Minimizing the Pain of Local Anesthesia Injection

Strazar

Leynes

Lalonde

2013

Plastic and Reconstructive Surgery

140

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There are now excellent techniques for minimizing anesthetic injection pain, with supporting evidence varying from anecdotal to systematic reviews. Medical students and residents can easily learn techniques that reliably limit the pain of local anesthetic injection to the minimal discomfort of only the first fine needlestick. By combining many of these conclusions and techniques offered in the literature, tumescent local anesthetic can be administered to a substantial area such as a hand and forearm for tendon transfers or a face for rhytidectomy, with the patient feeling just the initial poke.

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“…The presence and intensity of pain in response to needle change between the steps of drug preparation and administration were previously evaluated for intramuscularly administrable medications. In this randomized study (also with 50 participants), there was a significant difference in the perception of pain when comparing "conventional" and "emergent" techniques (20) . However, the same result could not be observed during a randomized trial in another study (17) involving subcutaneous administration of drugs.…”

Section: Discussionmentioning

confidence: 76%

Avaliação ultraestrutural de agulhas e seu papel no conforto durante a administração subcutânea de medicamentos

Pereira

Oliveira

Ferreira

et al. 2018

Rev. esc. enferm. USP

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RESUMO Objetivo Avaliar a morfologia de biséis de agulhas hipodérmicas após a aspiração de drogas e a percepção de conforto ocasionado pela troca ou não de agulhas entre preparo e administração de medicamentos pela via subcutânea. Método Pesquisa experimental realizada em dois momentos. Inicialmente, agulhas hipodérmicas foram analisadas por microscopia eletrônica de varredura e, em seguida, um ensaio piloto foi conduzido com os participantes, que indicaram o nível de conforto percebido no momento da penetração dos biséis das agulhas durante a administração pela via subcutânea. Resultados Participaram do estudo 41 pacientes adultos internados. Apesar de as agulhas terem apresentado de discreta a importante alteração morfológica, quando avaliadas por ultramicroscopia, os participantes deste estudo não foram capazes de relatar alterações sensoriais significativas durante a penetração destas nas duas técnicas adotadas. Conclusões A padronização de seringas com agulhas fixas ou o uso de uma única agulha tanto para o preparo quanto para a administração de medicamentos pela via subcutânea devem ser considerados como estratégias para redução da produção de resíduos perfurocortantes, diminuição do custo por procedimento e limitação do risco de contaminação de dispositivos considerados críticos.

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Effect on pain of changing the needle prior to administering medicine intramuscularly: a randomized controlled trial

Abstract: The results supported the hypothesis that changing the needle prior to administering the medicine significantly reduced pain intensity.

Cited by 38 publications

References 19 publications

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Minimizing the Pain of Local Anesthesia Injection

Avaliação ultraestrutural de agulhas e seu papel no conforto durante a administração subcutânea de medicamentos

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