Optimal length of intramuscular injection needle and drug absorption by ultrasound evaluation

Yasuhara, Yuko; Sakamaki, Sakiko; Tanioka, Tetsuya; Motoki, Kazushi; Sasakawa, Chiiko; Takase, Kensaku; Kawanishi, Chiemi

doi:10.2301/neurosonology.25.91

Cited by 4 publications

(5 citation statements)

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“…It is important to note, however, that the procedure for data collection was used in four other successful investigations by Tanioka, Yasuhara, and Sakamaki et al [19]- [21] [32]. This procedure provided credible data on diffusion location, rates, and absorption using RLAI.…”

Section: Discussionmentioning

confidence: 99%

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Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

Yasuhara¹,

Tanioka²,

Takase³

et al. 2016

OJPsych

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The aim of this study was to consider the characteristics of intramuscular diffusion status of risperidone and aripiprazole long acting injectable (LAI) by ultrasonography. Subjects were 40 adult subjects diagnosed with schizophrenia and treated with LAI [32 patients were risperidone LAI (RLAI) and 8 patients were aripiprazole LAI (ALAI)]. However, in this paper, only three cases (one RLAI case and 2 ALAI cases) were selected to illustrate the diffusion effects of both LAI. Dorsogluteal intramuscular (IM) injection sites were measured at prone position using the "double cross" method. Before LAI injection, the distance from the epidermis to the under-fascia (DEUF), and distance from the epidermis to the iliac bone (DEI) at the IM injection site were assessed by using ultrasonography: 1) the injection needle was inserted to the gluteus medius, and 2) observed the diffusion status within the muscle injected RLAI and ALAI were confirmed using the B-mode ultrasonography. Both RLAI and ALAI were depicted as high echogenicity with acoustic shadowing. It was considered that the diffusion states of LAIs by ultrasonography were important time course evaluations providing objective evidence.

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Section: Discussionmentioning

confidence: 99%

“…Previous study [18] reports injection needle lengths for optimal IM injection for adult subjects. Previous research using ultrasonographic data is used to detect insertion sites [19], depth of needle insertion into specific muscles [20], and visualization of medication dispersions [21].…”

Section: Introductionmentioning

confidence: 99%

Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

Yasuhara¹,

Tanioka²,

Takase³

et al. 2016

OJPsych

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“…This was evidenced by using an ultrasonic diagnostic apparatus 14) . Also, it was observed that both RLAI and ALAI were depicted as having high echogenicity with acoustic shadowing and high echogenic mass in the gluteus medius 15) .…”

Section: Evaluations Of Muscle Echogenicities In Patients Treated Witmentioning

confidence: 99%

Evaluations of muscle echogenicities in patients treated with second generation long acting injectable antipsychotics

et al. 2017

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IntroductionAntipsychotic depots or long-acting injections were introduced in the 1960s as a means of improving medication adherence and thereby enhancing desired clinical outcomes 1) . Several first-generation (FG)-long-acting injectable antipsychotics (LAIs) and three second-generation LAIs (SG-LAIs) are currently available for administration into either the gluteal or deltoid muscle. These LAIs are administered by intramuscular (IM) injection. A single injection effect lasts within the range of 1 week to 3 months, depending on the compound and formulation 2,3) . Our previous study evaluated the B-mode findings of the muscle infiltrated with second generation long acting injectable antipsychotics (SG-LAIs). SG-LAIs were seen as a high-echogenicity mass with marked acoustic shadowing in the gluteus medius muscle. The aim of this study was to examine the echogenicities of the muscle with SG-LAI. This study demonstrated 3 patients with schizophrenia under treatment with risperidone (RLAI), paliperidone (PLAI) and aripiprazole (ALAI) (one case each). Quantitative diagnostic ultrasound imaging has been proposed as a method of estimating muscle quality using echogenicities. Grayscale histogram analysis of Photoshop Premiere Elements 14.0 was used to determine the muscle tissue echogenicity in a region of interest (ROI). The pre-and post-injected SG-LAI echogenicities were analyzed using a paired t-test with a significance level of 5%. Each SG-LAIs could be illustrated as high echogenic masses with acoustic shadowing. The corresponding grayscale histogram values of selected ROI in the injected muscles were significantly increased in all cases. It was considered that the diffusion states of SG-LAIs by ultrasonography were important time course evaluations providing objective evidence. Evaluations of muscle echogenicities in patients treated

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“…In previous studies using ultrasonography, the "distance from the epidermis to the under-fascia" and "distance from the epidermis to the iliac bone" of the buttocks at the dorsogluteal and ventrogluteal sites in healthy Japanese volunteer subjects 8) and patients with schizophrenia were measured 9,10) in order to evaluate the optimal IM injection needle length 11) and the optimal gluteal muscular injection needle should be 40-50mm in length. The IM administrated LAIs showed high-echogenicity masses with acoustic shadowing 12,13) .…”

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confidence: 96%

Evaluations of echogenicity in gluteal muscle in patients with schizophrenia treated with second generation long-acting injectable antipsychotics: risperidone or aripiprazole

et al. 2018

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Second generation long-acting injectable antipsychotics (SG-LAIs) injected muscle region show high-echogenicity with acoustic shadowing on B-mode scan. This study aimed to distinguish two specific types of SG-LAIs at the gluteal muscle. Forty-seven patients [risperidone (RLAI): 28 patients, aripiprazole (ALAI): 19 patients] were examined using grayscale histogram analysis of echo-intensities. Pre-and immediately after (post)-injected SG-LAI region of interest (ROI) was placed on the same sites of gluteal muscle, and the grayscale histograms were recorded. Pre-and post-injected echogenicity values were analyzed using paired t-test, and Pearson's moment correlation coefficient. Mixed effects model regression analysis was performed on variations in average echogenicity from age and medication type. Statistical significance was at 5%. There was no significant correlation between age and average echogenicity of ROI pre-intramuscular (IM) injection (r = 0.26, p = 0.078). In both RLAI and ALAI, the mean echogenicity post-IM injection was significantly higher than pre-IM injection (p < 0.001). With increasing age, the values of echogenicity of post-injection was decreased significantly (p = 0.002). The increasing values of the echo-intensities post-injections of RLAI showed significantly higher than ALAI (p = 0.002). It was considered that administered type of LAI could be identified because each LAI exhibits specific echographically findings, it also will be able to applied clinically.

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Optimal length of intramuscular injection needle and drug absorption by ultrasound evaluation

Cited by 4 publications

References 5 publications

Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography

Evaluations of muscle echogenicities in patients treated with second generation long acting injectable antipsychotics

Evaluations of echogenicity in gluteal muscle in patients with schizophrenia treated with second generation long-acting injectable antipsychotics: risperidone or aripiprazole

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