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Bio-Design and Manufacturing  2018 Vol.1 No.3 P.161-170

http://doi.org/10.1007/s42242-018-0018-x


A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry


Author(s):  Erfan Soliman, Sarujan Ranjan, Tianyou Xu, Carol Gee, Aidan Harker, lvaro Barrera, John Geddes

Affiliation(s):  Department of Engineering Sciences, Institute of Biomedical Engineering, Old Road Campus Research Building, University of Oxford, Oxford OX3 7DQ, UK; more

Corresponding email(s):   soliman@post.harvard.edu, sarujan.ranjan@bartshealth.nhs.uk, tx213@nyu.edu

Key Words:  Intramuscular injection · Gluteal · Subcutaneous · Ultrasound · Computed tomography · Antipsychotic


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Erfan Soliman, Sarujan Ranjan, Tianyou Xu, Carol Gee, Aidan Harker, lvaro Barrera, John Geddes . A narrative review of the success of intramuscular gluteal injections and its impact in psychiatry[J]. Journal of Zhejiang University Science D, 2018, 1(3): 161-170.

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Abstract: 
There are 12 billion injections given worldwide every year. For many injections, the intramuscular route is favoured over the subcutaneous route due to the increased vascularity of muscle tissue and the corresponding increase in the bioavailability of drugs when administered intramuscularly. This paper is a review of the variables that affect the success of intramuscular injections and the implications that these success rates have in psychiatry and general medicine. Studies have shown that the success rates of intended intramuscular injections vary between 32 and 52%, with the rest potentially resulting in inadvertent subcutaneous drug deposition. These rates are found to be even lower for certain at-risk populations, such as obese patients and those on antipsychotic medications. The variables associated with an increased risk of injection failure include female sex, obesity, site of injection, and subcutaneous fat depth. New guidelines and methods are needed in order to address this challenge and ensure that patients receive optimum care. Looking forward, the best way to improve the delivery of intramuscular injections worldwide is to develop uniform algorithms or innovative medical devices to confirm or guarantee successful delivery at the bedside.

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