Department of Fundamentals of Nursing, Hamidiye Faculty of Nursing, University of Health Sciences, İstanbul, Turkey.
Department of Palliative Care, Republic of Türkiye Ministry of Health Silivri State Hospital, İstanbul, Turkey.
Int J Older People Nurs. 2024 Nov;19(6):e12655. doi: 10.1111/opn.12655.
Muscle, subcutaneous tissue and total tissue thicknesses are important factors in successful intramuscular injection. Muscle mass decreases and subcutaneous tissue increases with age. This may negatively affect the safety and effectiveness of intramuscular injection in older adults by increasing the risk of bone contact and subcutaneous drug administration. Intramuscular injection sites should be evaluated in this respect, but no previous study has evaluated the most appropriate sites for safe and effective intramuscular injection in older adults.
This study aimed to examine the safety of dorsogluteal and ventrogluteal injection sites in older adults.
This cross-sectional study included 171 older adults who presented to the radiology clinic of a hospital between November 2022 and February 2023. We collected the study data using a descriptive characteristics form and an ultrasonographic measurement form. To complete the descriptive characteristics form, we interviewed the participants and measured their waist circumference, hip circumference, weight and height. Muscle, subcutaneous tissue and total tissue thicknesses at the ventrogluteal and dorsogluteal sites were determined by ultrasonography. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline.
At the ventrogluteal and dorsogluteal sites, respectively, total tissue thicknesses were 59.43 ± 11.21 and 48.78 ± 9.68 mm, subcutaneous tissue thicknesses were 20.07 ± 6.64 and 22.97 ± 7.40 mm and muscle thicknesses were 40.13 ± 5.59 and 25.61 ± 4.30 mm. Tissue thicknesses at both sites differed according to sex, weight, hip circumference and waist circumference (p < 0.05). Although both sites were acceptable according to the tissue thickness thresholds for intramuscular injection given in the literature (subcutaneous tissue < 25 mm, total tissue > 35 mm), the ventrogluteal site was more advantageous in terms of greater muscle thickness and lower subcutaneous tissue thickness.
The results of this study indicated that both the ventrogluteal and dorsogluteal sites are safe for intramuscular injections in older adults in terms of tissue thickness. However, the ventrogluteal site may be safer for older adults because of the lower risk of bone contact and subcutaneous injection. Further studies are needed on this subject.
This study is important in terms of determining the safe and effective gluteal site for IM injection in older people aged 65 and over, preventing complications that may arise from site selection, and developing nursing policies that consider older people as a special group in the selection of IM injection sites.
肌肉、皮下组织和总组织厚度是肌肉内注射成功的重要因素。随着年龄的增长，肌肉量减少，皮下组织增加。这可能会通过增加骨骼接触和皮下药物给药的风险，对老年人的肌肉内注射的安全性和有效性产生负面影响。应从这方面评估肌肉内注射部位，但以前没有研究评估过老年人安全有效的肌肉内注射最适宜的部位。
本研究旨在检查老年人臀肌和臀肌注射部位的安全性。
本横断面研究纳入了 2022 年 11 月至 2023 年 2 月间在一家医院放射科诊所就诊的 171 名老年人。我们使用描述性特征表和超声测量表收集研究数据。为了完成描述性特征表，我们对参与者进行了访谈并测量了他们的腰围、臀围、体重和身高。通过超声检查确定臀肌和臀肌注射部位的肌肉、皮下组织和总组织厚度。本研究遵循《加强观察性研究的报告：流行病学（STROBE）指南》。
臀肌和臀肌注射部位的总组织厚度分别为 59.43±11.21mm 和 48.78±9.68mm，皮下组织厚度分别为 20.07±6.64mm 和 22.97±7.40mm，肌肉厚度分别为 40.13±5.59mm 和 25.61±4.30mm。两个部位的组织厚度均因性别、体重、臀围和腰围的不同而有所差异（p<0.05）。尽管根据文献中肌肉内注射的组织厚度阈值（皮下组织<25mm，总组织>35mm），两个部位都可接受，但臀肌注射部位的肌肉厚度更大，皮下组织厚度更低，因此更有优势。
本研究结果表明，从组织厚度的角度来看，臀肌和臀肌注射部位对老年人的肌肉内注射都是安全的。然而，由于接触骨骼和皮下注射的风险较低，臀肌注射部位对老年人可能更安全。需要进一步研究这一主题。
本研究对于确定 65 岁及以上老年人肌肉内注射的安全有效臀部部位，防止因部位选择不当而引起的并发症，以及制定考虑老年人作为特殊群体的肌肉内注射部位选择护理政策具有重要意义。
