Introduction: Intramuscular injection is a commonly used parenteral method that provides rapid and reliable drug action. Medications can be injected into the deltoid muscle, the superficial gluteal muscles, and the anterior thigh muscles. Although routinely practiced, the technique carries risks, often due to incorrect site selection or improper administration. These issues are closely related to regional anatomy. Purpose: This thesis aims to provide an overview of the muscle regions used for intramuscular injections, describe standard administration sites, and outline methods for locating them. It also highlights recent best practices in intramuscular injection. The goal is to identify factors that improve the safety and effectiveness of intramuscular injection, ultimately supporting better patient outcomes. Methods: A literature review was conducted using Medline, ScienceDirect, PubMed, Google Scholar, DiKUL, and COBISS. The review included anatomical descriptions, clinical guidelines, and studies examining safety in site selection, injection techniques, and needle dimensions. A total of 87 literature sources were included. Results: In adults, the deltoid muscle is the most frequently used, especially for vaccinations. In the gluteal region, injections are administered into the dorsogluteal or ventrogluteal areas, with preference for the ventrogluteal site due to greater safety. In the anterior thigh, injections can be placed into the vastus lateralis muscle and into the rectus femoris muscle, although the use of the rectus femoris muscle is generally discouraged. Serious complications include injury to the axillary nerve in the deltoid region, sciatic nerve in the gluteal region, and femoral nerve in the thigh region. Our results reveal discrepancies between clinical practice and existing guidelines, most notably in the gluteal region, where the dorsogluteal site remains frequently used despite limited recommendations. Several studies suggest alternate injection sites or improved site determination techniques. Factors such as body weight, sex, muscle mass, and drug properties significantly affect the site choice, technique, and needle dimensions. Discussion and conclusion: Our findings emphasize the need for standardization of this procedure. A thorough understanding of anatomy, careful site selection based on patient characteristics, and objective methods for needle selection are essential. The skill and competence of healthcare professionals also play a key role in ensuring safe and effective practice.
|
