Influence of gender, <scp>BMI</scp> and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites

Larkin, Theresa A; Ashcroft, Elfriede; Hickey, Blake Anthony; Elgellaie, Asmahan

doi:10.1111/jocn.13923

Cited by 19 publications

(52 citation statements)

References 28 publications

(99 reference statements)

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“…2a) in order to prevent injury to the sciatic nerve [29,30]. Moreover, administration in the ventrogluteal region diminishes the possibility of subcutaneous injection in overweight patients since the layer of subcutaneous fat is less thick in the ventrogluteal region compared to the dorsogluteal region [31]. It is well known that knee OA is more common in patients with a BMI > 27 kg/m 2 [32].…”

Section: Interventionmentioning

confidence: 99%

Effectiveness of intramuscular gluteal glucocorticoid injection versus intra-articular glucocorticoid injection in knee osteoarthritis: design of a multicenter randomized, 24 weeks comparative parallel-group trial

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Runhaar

Bos

et al. 2020

BMC Musculoskelet Disord

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Background: The knee is symptomatically the most frequent affected joint in osteoarthritis and, in the Netherlands and other Western countries, is mainly managed by general practitioners (GPs). An intra-articular glucocorticoid injection is recommended in (inter) national guidelines for patients with knee osteoarthritis as an option for a flare of knee pain and/or for those who are not responding well to pain medication. An innovative approach that could replace the intra-articular injection is an intramuscular gluteal glucocorticoid injection. An intramuscular injection is easier to perform than an intra-articular injection with lesser risk of severe local adverse reactions. We hypothesize that intramuscular gluteal glucocorticoid injection is non-inferior in reducing knee pain compared to intra-articular glucocorticoid injection, with potentially a longer lasting effect than intra-articular injection. Methods/design: The study will be a pragmatic randomized controlled non-inferiority trial with two parallel groups. A total of 140 patients aged 45 years and older with knee osteoarthritis who contacted their general practitioner and have persistent knee pain (score ≥ 3 on 0-10 numerical rating scale; 0 = no knee pain) will be included. Patients will be randomly allocated (1:1) to an injection of 40 mg triamcinolone acetonide intra-articular in the knee joint or intramuscular in the ipsilateral ventrogluteal area. The effect of treatment will be evaluated by questionnaires at 2, 4, 8, 12, and 24 weeks after injection. The primary outcome is patients' reported severity of knee pain measured with the pain subscale of the Knee injury and Osteoarthritis Outcome Score 4 weeks after injection. Statistical analysis will be based on both the per-protocol and the intention-to-treat principle.(Continued on next page)

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Section: Interventionmentioning

confidence: 99%

Effectiveness of intramuscular gluteal glucocorticoid injection versus intra-articular glucocorticoid injection in knee osteoarthritis: design of a multicenter randomized, 24 weeks comparative parallel-group trial

Mol

Runhaar

Bos

et al. 2020

BMC Musculoskelet Disord

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“…Na voljo so tri skupine mišic: deltoidna mišica nadlakti, glutealne mišice zadnjice ter vastus lateralis in rectus femoris v sklopu štiriglave stegenske mišice (Ogston-Tuck, 2014). Izbira mesta in tehnika aplikacije intramuskularne injekcije sta povezani tako s pozitivnimi kot negativnimi izidi pri pacientu (Larkin, et al, 2017a(Larkin, et al, , 2017b.…”

Section: Uvodunclassified

“…Kljub temu pa je dorzoglutealno področje v praksi pogosto uporabljeno za aplikacijo intramuskularne injekcije. Pri tem poleg možne aplikacije zdravila v krvni obtok obstaja tudi nevarnost, da bo zdravilo aplicirano v podkožno tkivo in ne v mišico, saj je omenjeno področje pri mnogih obdano z zajetnim delom podkožnega maščobnega tkiva (Larkin et al, 2017b). Poleg omenjenih zapletov je eden od izidov intramuskularne injekcije tudi pojav bolečine pri pacientu.…”

Section: Uvodunclassified

“…S pomočjo ocenjevalnega orodja NIH-NHLBI (2014) smo sedem člankov ocenili z »dobro« oceno kakovosti (Ağaç, et al, 2011;Ozdemir, et al, 2013;Kara & Güneş, 2014;Tuğrul & Khorshıd, 2014;Coskun, et al, 2016;Najafi, et al, 2018;Şahin & Eşer, 2018), dvanajst člankov s »povprečno« oceno kakovosti (Barnhill, et al, 1996;Engstrom, et al, 2000;Alavi, 2007;Derya, et al, 2014;Kaya, et al, 2014;Thomas, et al, 2016;Yilmaz, et al, 2016;Kant & Akpinar, 2017;Larkin, et al, 2017aLarkin, et al, , 2017bRaddadi, et al, 2017;Kadioglu, 2018) in šest člankov s »slabo« oceno kakovosti (Nisbet, 2006;Mishra & Stringer, 2010;Palma & Strohfus, 2013;Suhrabi & Taghinejad, 2014;Sisson, 2015;Kaya, et al, 2016).…”

Section: Ocena Kakovostiunclassified

“…Med njima obstajajo številne razlike, glede katerih se razlikujejo tudi posamezna mnenja in ugotovitve. Na primer ugotovitev, da naj bi dorzoglutealno področje imelo širše mišice -Coskun in sodelavci (2016) navajajo 28,35±7 mm -poleg tega tudi večjo debelino podkožnega tkiva in večjo skupno debelino tkiva kot na ventroglutealnem področju (Coskun, et al, 2016;Larkin, et al, 2017aLarkin, et al, , 2017b. Kaya in sodelavci (2016) pa menijo, da je debelina mišičnega tkiva na ventroglutealnem področju večja kot na dorzoglutealnem.…”

Section: Značilnosti Področja Aplikacije Ter Konstitucionalne Značilnunclassified

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Varnost pri aplikaciji intramuskularne injekcije

2020

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Uvod: Aplikacija intramuskularne injekcije je pogosta intervencija v zdravstveni negi, ki za pacienta predstavlja potencialno varnostno tveganje. Namen raziskave je bil ugotoviti dejavnike, povezane z aplikacijo intramuskularne injekcije v glutealno področje, ki vplivajo na pozitivne in negativne izide pri pacientu.Metode: Izveden je bil sistematični pregled literature v podatkovnih bazah PubMed, Medline, ScienceDirect in CINAHL. V pregled so bili vključeni članki glede na ustreznost vsebine, vrsto raziskav, polno dostopnost, jezik ter objavo do decembra 2018. Iskanje je potekalo s pomočjo ključnih besed: »patient«, »intramuscular dorsogluteal injection«, »intramuscular ventrogluteal injection«, »dorsogluteal site«, »ventrogluteal site«, »outcome«, »injury«, »safety«, »complications«, »pain«. Kakovost posamičnih raziskav je bila ocenjena s pomočjo orodja National Heart Lung and Blood Institute. Zbrani podatki so bili sintetizirani z metodo analize vsebine.Rezultati: Izmed 95 identificiranih zadetkov je bilo v končno analizo vključenih 25. Ugotovitve so bile združene v pet kategorij, dejavnikov, ki vplivajo na varnost pri aplikaciji intramuskularne injekcije: značilnosti področja aplikacije ter konstitucionalne značilnosti pacientov, izbor področja in vbodnega mesta aplikacije, tehnika aplikacije intramuskularne injekcije, aspiracija in dejavniki, povezani z bolečino, in tehnike zmanjševanja bolečine.Diskusija in zaključek: Za zagotavljanje varnosti pri aplikaciji intramuskularne injekcije je potrebno poznavanje dejavnikov, ki vplivajo na izide pri pacientu. Zaradi ugotovljenih pomanjkljivosti v praksi bi bilo smiselno raziskati znanje zdravstvenih delavcev o aplikaciji intramuskularne injekcije.

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Effect of Intramuscular vs Intra-articular Glucocorticoid Injection on Pain Among Adults With Knee Osteoarthritis

et al. 2022

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IMPORTANCE Intra-articular (IA) glucocorticoid injection is widely used in patients with knee osteoarthritis (OA), but the safety of this technique is in question among physicians. Intramuscular (IM) glucocorticoid injection could be an alternative approach. OBJECTIVE To investigate whether an IM glucocorticoid injection is noninferior to an IA glucocorticoid injection in reducing knee pain for patients with knee OA in primary care. DESIGN, SETTING, AND PARTICIPANTSThe KIS trial, a multicenter, open-label, randomized clinical noninferiority trial including patients with symptomatic knee OA, was conducted in 80 primary care general practices in the southwest of the Netherlands. The study was conducted from March 1, 2018, to July 28, 2020. INTERVENTIONS Patients were randomly allocated to receive an injection of triamcinolone acetonide, 40 mg, either IM in the ipsilateral ventrogluteal region or IA in the knee joint. All patients were followed up for 24 weeks. MAIN OUTCOMES AND MEASURESThe pain score at 4 weeks measured with Knee Injury and Osteoarthritis Outcome Score (range, 0-100; 0 indicates extreme pain), with a noninferiority margin of −7 (IM minus IA). A per-protocol analysis was prespecified as the primary analysis.RESULTS A total of 145 patients (94 women [65%]; mean [SD] age, 67 [10] years) were included; of these, 138 patients (IM, 72; IA, 66) were included in the per-protocol analysis. Clinically relevant improvements in knee pain were reached up to 12 weeks after the injection in both groups. At 4 weeks, the estimated mean difference in the Knee Injury and Osteoarthritis Outcome Score between the 2 groups was −3.4 (95% CI, −10.1 to 3.3). Noninferiority could not be declared because the lower limit exceeded the noninferiority margin. Intramuscular injection was noninferior to IA injection at 8

show abstract

Influence of gender, BMI and body shape on theoretical injection outcome at the ventrogluteal and dorsogluteal sites

Cited by 19 publications

References 28 publications

Effectiveness of intramuscular gluteal glucocorticoid injection versus intra-articular glucocorticoid injection in knee osteoarthritis: design of a multicenter randomized, 24 weeks comparative parallel-group trial

Effectiveness of intramuscular gluteal glucocorticoid injection versus intra-articular glucocorticoid injection in knee osteoarthritis: design of a multicenter randomized, 24 weeks comparative parallel-group trial

Varnost pri aplikaciji intramuskularne injekcije

Effect of Intramuscular vs Intra-articular Glucocorticoid Injection on Pain Among Adults With Knee Osteoarthritis

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