The Effect of Injection Speed on the Pain of Lidocaine Infiltration

Objective : To determine whether reducing the speed of injection is effective in reducing injection pain for buffered and unbuffered lidocaine solutions.
Methods : A prospective, single-blind, randomized, crossover, laboratory study was performed. Adult volunteers were recruited from ED staff at an urban teaching hospital to serve as subjects. Twenty-nine subjects each received 4 1-mL injections into the dorsum of the hands. Each subject received fast and slow injections of buffered and unbuffered lidocaine. Subjects rated the pain of each injection on a 100-mm visual analog scale (VAS). Mean pain scores for each intervention were compared using analysis of variance.
Results : The mean pain VAS score for fast injection of buffered lidocaine was 14.1 mm. For slow buffered injection, the mean pain score was 11.4 mm (p = 0.98). For unbuffered lidocaine, the means were 28.7 mm for fast injection and 22.2 mm for slow injection (p = 0.40).
Conclusions : Reducing injection speed did not produce a statistically significant change in injection pain for either buffered or unbuffered solutions.     

Effect of the Buzzy Application on Pain and Injection Satisfaction in Adult Patients Receiving Intramuscular Injections

AimThe aim of this study was to investigate the effect of the Buzzy application on pain and satisfaction during injections.BackgroundIntramuscular injections usually cause some degree of pain at the injection site. Patients are often afraid of receiving injections because they perceive that it will be painful.DesignThe study was a single-blind, randomized controlled trial.MethodPatients (n = 65) who receive diclofenac sodium intramuscularly at a state hospital in a city in the western region of Turkey were included in the study. The study data were collected by The Patient Information Form and Visual Analog Scale (VAS). Pain intensity and injection satisfaction scores were evaluated using the VAS.ResultsAccording to the findings of this research, the post-injection pain intensity and injection satisfaction scores of patients in the application group were found to be higher than in the control group.ConclusionIn conclusion, the Buzzy device has the potential to reduce injection related pain in adult patients who may be fearful of receiving such injections.     

Z径路肌内注射法和常规肌内注射法应用效果比较

目的对国内常规肌内注射法和Z-径路（Z-track）肌内注射法的应用效果进行比较研究。方法将200例患者分为Z径路肌内注射法和常规肌内注射法组,分别观察并记录注射后药（血）液外渗和疼痛不良反应发生情况。结果 Z径路组与常规组在药液外溢、疼痛发生率方面均有统计学意义。结论采用Z型肌内注射法可以减少药液外溢,减轻疼痛,值得临床推广应用。     

The Effect of Kangaroo Care on Behavioral Responses to Pain of an Intramuscular Injection in Neonates

PURPOSE. This study aims to assess the efficacy of Kangaroo Care (KC) on behavioral responses of term neonates to the pain of an intramuscular injection. DESIGN AND METHODS. One hundred healthy term neonates were enrolled and randomly assigned to intervention and control groups. In the intervention group, the neonate was held in KC for 10 min before the injection and remained in KC for the duration of the procedure. The primary outcome measure was the cumulative Neonatal Infant Pain Scale (NIPS) score immediately after injection. RESULTS. The cumulative NIPS score immediately after injection in the intervention group was significantly lower (p < .001) than in the control group. PRACTICE IMPLICATIONS. KC given before injection seems to effectively decrease pain and should be considered for minor invasive procedures in neonates.     

Effects of Intramuscular Anesthesia on the Expression of Primary and Referred Pain Induced by Intramuscular Injection of Hypertonic Saline

Intramuscular injection of hypertonic saline produces pain in the belly of the injected muscle (primary pain) and, often, pain that projects distally (referred pain). While it is known that referred pain can be induced during complete sensory block of the distal site, there is little evidence as to whether the perception of referred pain depends on ongoing input from the primary stimulus. We assessed whether blocking the noxious input following the induction of pain blocks the primary but not the referred pain. A cannula was inserted into the tibialis anterior muscle in 15 subjects (8 male, 7 female). In a quasi-random crossover design conducted over 2 experimental sessions, each subject received a bolus intramuscular injection of .5 mL of 5% hypertonic saline, followed 90 seconds later by either: A) A second bolus injection or; B) An injection of 2 mL lignocaine through the same cannula. Protocol A was followed 60 seconds later by either a sham injection or an injection of lignocaine, while protocol B was followed 60 seconds later by either a sham injection or an injection of hypertonic saline. Subjects mapped the areas of primary and referred pain, and rated the intensities at these sites every 30 seconds until the cessation of pain. In all subjects, the area and intensity of primary pain rapidly disappeared within 7.5 minutes of intramuscular lignocaine injection (P < .02 relative to the nonanesthesia condition). With the exception of 2 subjects, in whom the referred pain continued in the absence of primary pain, the referred pain declined in parallel with local pain: the mean total pain intensity declined by 74% in both regions. We conclude that the maintenance of referred muscle pain usually depends on ongoing noxious inputs from the site of primary muscle pain.PerspectiveReferred pain is a significant clinical problem, and commonly occurs with pain originating in muscle but not from skin. It is important to know the primary source of the pain so that treatment can be directed to this site rather to the site of referral.     

指压按摩法减轻肌肉注射疼痛的临床研究

肌肉注射法在临床工作中很常用 ,而某些刺激性较强的药物注射时疼痛较剧烈 ,有的病人因无法忍受此疼痛被迫停止注射 ,使临床用药受限 ,并影响疾病的治疗。为了能顺利完成治疗用药 ,并能减轻病人注射时的疼痛 ,有人曾提出 :肌肉注射时 ,边推药边按压序边穴能减轻注射时的疼痛程度 ,但不能减轻进针时的疼痛 ,对疼痛敏感的病人仍不是最好的方法。为此 ,采用指压按摩法肌肉注射 ,经临床观察 ,效果良好 ,现报告如下。1　资料及方法1.1　一般资料　选择清醒、对疼痛能正确描述、痛感觉正常、注射部位无感染、硬结、创伤等的住院肌肉注射病人 180例…     

艾灸治疗肌肉注射后硬结的效果观察

艾灸治疗肌肉注射后硬结的效果观察ＣｕｒａｔｉｖｅＥｆｅｃｔｏｆＭｏｘｉｂｕｓｔｉｏｎｏｎｔｈｅＩｎｄｕｒａｔｉｏｎＩｎｄｕｃｅｄｂｙＩｎｔｒａｍｕｓｃｕｌａｒＩｎｊｅｃｔｉｏｎ古兰华ＧｕＬａｎｈｕａ（Ｗｏｒｋｅｒ’ｓＨｏｓｐｉｔａｌｏｆＨｕａｔｉｎ...     

黄体酮Z径路肌内注射法的效果观察

目的探讨黄体酮采用Z径路肌内注射法的效果。方法选择200例先兆流产需使用黄体酮肌内注射治疗的患者,随机分为两组各100例。对照组采用常规肌内注射法;改良组采用Z径路肌内注射法,于注射前以左手食指、中指和无名指使待注射部位皮肤及皮下组织朝同一方向侧移（皮肤侧移1～2 cm左右）,然后以左手拇指朝同一方向绷紧固定局部皮肤,维持到拔针后,迅速松开左手,此时侧移的皮肤和皮下组织位置还原,原先垂直的针刺通道随即变成Z型。观察两组患者7 d内药（血）液渗出及皮下硬结发生情况。结果改良组药（血）液渗出及皮下硬结发生率明显低于对照组（P〈0.05）。结论Z径路肌内注射法在黄体酮治疗中能有效减少黄体酮外渗及局部硬结形成,保证黄体酮剂量的准确,减少患者的痛苦。     

Oxytocin Effects on Pain Perception and Pain Anticipation

There is an ongoing debate whether the neuropeptide oxytocin (OT) modulates pain processing in humans. This study differentiates behavioral and neuronal OT effects on pain perception and pain anticipation by using a Pavlovian conditioning paradigm. Forty-six males received intranasally administered OT in a randomized, double-blind, placebo-controlled group design. Although OT exerted no direct effect on perceived pain, OT was found to modulate the blood oxygen level-dependent response in the ventral striatum for painful versus warm unconditioned stimuli and to decrease activity in the anterior insula (IS) with repeated thermal pain stimuli. Regarding pain anticipation, OT increased responses to CS_pain versus CS_minus in the nucleus accumbens. Furthermore, in the OT condition increased correct expectations, particularly for the most certain conditioned stimuli (CS)–unconditioned stimuli associations (CS_minus and CS_pain) were found, as well as greatest deactivations in the right posterior IS in response to the least certain condition (CS_warm) with posterior IS activity and correct expectancies being positively correlated. In conclusion, OT seems to have both a direct effect on pain processing via the ventral striatum and by inducing habituation in the anterior IS as well as on pain anticipation by boostering associative learning in general and the neuronal conditioned fear of pain response in particular.PerspectiveThe neuropeptide OT has recently raised the hope to offer a novel avenue for modulating pain experience. This study found OT to modulate pain processing and to facilitate the anticipation of pain, inspiring further research on OT effects on the affective dimension of the pain experience.     

艾司洛尔预处理对丙泊酚注射痛的影响

目的：观察小剂量艾司洛尔预处理对丙泊酚静脉注射痛的影响。方法：美国麻醉医师协会（ASA）分级为Ⅰ～Ⅱ级且择期行全麻手术的患者120例,随机分为3组,每组40例。经左前臂桡侧浅静脉置入20G套管留置针。麻醉诱导前左上臂包裹气压止血带,加压至70mmHg后,按分组以3mL/10s速度分别静脉注射：0.9%氯化钠液3mL（C组）,利多卡因0.5mg/kg（L组）,艾司洛尔0.25mg/kg（E组）,60s后松开止血带,将2mg/kg丙泊酚在20s内缓慢注入。随后静脉注射芬太尼、维库溴胺,行气管插管全麻。采用4分制记录3组患者丙泊酚注射痛评分,并记录药物预注前（T0）、气管插管前（T1）、气管插管后1min（T2）、气管插管后3min（T3）的平均动脉压（MAP）和心率（HR）。结果：注射痛的发生率C组为65%（26/40）,而L组为10%（4/40）,E组为25%（10/40）,与C组相比显著降低（P〈0.01）。L组和E组中度和重度疼痛的发生率均显著低于C组（P〈0.05和P〈0.01）。E组与L组比较,差异无统计学意义（P〉0.05）。结论：小剂量艾司洛尔预处理合用止血带可有效缓解丙泊酚注射痛。     

氟比洛芬酯用于防治丙泊酚注射痛的临床观察

目的观察氟比洛芬酯防治丙泊酚注射痛的疗效。方法将100例ASAⅠ-Ⅱ级择期手术患者随机分成4组,每组25例。各组患者于注射丙泊酚前均在前臂用止血带人为阻断血流2min后分别静推利多卡因40mg（A组）、甲氧氯普胺10mg（B组）、氟比洛芬酯50mg（C组）、生理盐水5mL（D组）,注射完毕1min后松开止血带,静推丙泊酚注射液行麻醉诱导,观察每组疼痛发生率,并根据Ambesh法评分。结果A、B、C组的注射痛发生率和疼痛程度明显低于D组,差异有统计学意义（P〈0．01）。结论氟比洛芬酯能有效降低丙泊酚注射痛的发生率并减轻疼痛程度,与利多卡因、甲氧氯普胺的疗效相当。     

在卫生列车上肌内注射技术改进的效果评价

目的探讨适应列车环境的肌内注射操作技术。方法按照临床使用的肌内注射技术方法对操作者进行训练,操作者准确掌握之后,在开动的列车上进行操作,对操作的结果进行评价;在肌内注射操作流程和注射技术方法等方面进行改进,采用改进后的技术方案在开动的列车上操作,并评价。结果临床肌内注射的技术在列车上应用,操作时间长、质量差,与陆地相比用时长、评分差,差异有统计学意义（P〈0．01）;经过改进后的肌内注射技术在列车上实施,操作时间、质量与改进前方法比较,有明显的好转（P〈0．01）。结论在特定的救治环境应有相适应的肌内注射技术,改进后的肌内注射技术方法能较好地适应列车上的特殊要求,基本形成了列车肌内注射技术方案。     

黄体酮注射液Z径路肌内注射法的应用效果

目的观察Z径路肌内注射法在黄体酮注射液治疗中的应用效果。方法便利抽样法选择2012年1-12月在江门市新会区人民医院接受体外授精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)术后需黄体酮支持治疗的患者100例,采用自身对照,左侧应用常规肌内注射法(对照组),右侧应用Z径路肌内注射法(观察组)。观察记录每例患者两侧臀部注射黄体酮1、4、8、12周后药液外渗、硬结、疼痛程度及瘙痒发生情况。结果 Z径路注射法较常规注射法药液外渗、局部不良反应发生率低,两者比较有统计学意义(均P0.01)。结论 Z径路肌内注射法在黄体酮治疗中能有效减少药液外渗及局部不良反应的发生率,确保黄体酮的剂量和疗效,减轻患者痛苦,提高护理工作质量。     

窦氏烧伤药油布治疗肌肉注射后局部肿痛23例

窦氏烧伤药油布治疗肌肉注射后局部肿痛２３例Ｔｒｅａｔｍｅｎｔｏｆ２３ＣａｓｅｓｏｆＬｏｃａｌＳｗｅｌｉｎｇａｎｄＰａｉｎＣａｕｓｅｄｂｙＩｎｔｒａｍｕｓｃｕｌａｒＩｎｊｅｃｔｉｏｎＷｉｔｈＤｏｕｓｈｉＳｈａｏｓｈａｎｇＣｏｍｐｒｅｓｓ林丽云ＬｉｎＬ...     

低分子肝素皮下注射持续时间对皮下出血和疼痛的影响

目的：评价低分子肝素（Low molecular weight heparins,LMWH）皮下注射持续时间对注射后皮下出血和疼痛的影响。方法：纳入2003年～2004年3月于我院行LMWH皮下注射的住院患者52例,以肚脐两侧作为注射点,任选一侧行首次注射,12h后于另一侧以相同剂量注射。脐右注射持续10秒（对照组）,脐左持续30秒（实验组）。于注射后48h、72h观察注射点有无皮下出血,并用透明纸质毫米尺测量出血面积,用视觉类比量表（Visual analog scale,VAS）测量疼痛强度,记录疼痛持续时间。采用卡方检验及配对t检验对两组皮下出血发生率及面积、疼痛强度及持续时间等指标进行对比分析。结果：实验组和对照组皮下出血的发生率分别为38．5％（n＝20）和61．5％（n＝32）（P＝0．035）。注射后48h、72h,实验组的出血面积均显著低于对照组（48h：17．5±7．3mm^2VS 101．2±15．0mm^2,P＝0．008;72h：20．7±8．0mm^2VS110．4±13．5mm^2,P=0．016）。实验组的注射后疼痛积分为13．0±6．4mm,对照组为21．5±7．0mm（P=0．021）。实验组疼痛持续时间显著低于对照组（42．5±14．2S比73．2±20．0s,P=0．030）。结论：肝素皮下注射持续时间能显著影响注射后皮下出血和疼痛形成,注射时间持续至30秒能有效降低皮下出血发生率及面积,并显著减轻疼痛强度、缩短疼痛时间。     

采用梅花形注射点氯丙嗪肌注的研究

为探讨梅花形注射法肌注氯丙嗪用于精神科临床的可能，对１００例住院病人随机分为实验组和对照组各５０例，采用上述方法与常规肌肉注射对照。结果表明：两线完成观察期全程的例数，注射部位出现局部反应的例数，接受注射平均天数，注射部位最初出现局部反应平均天数，注射部位红、肿、硬结、疼痛反应每天评分等方面，经ｘ＾２检验或ｔ检验，Ｐ值小于０．００１，差异有高度显著性。实验组采用梅花形注射法效果明显优于对照组。作者     

新斯的明足三里封闭与肌肉注射治疗产后尿潴留的临床观察

运用中医经络理论，采用新斯的明足三里穴位封闭法（Ａ组）治疗产后尿潴留，并与肌肉注射新斯的明法（Ｂ组）相比较。结果显示：Ａ组疗效显著高于Ｂ组