Comparison of the Efficacy of Shotblocker and Acupressure in Reducing Pain Due to Intramuscular Injection

Study Overview
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Brief Summary
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Various non-pharmacological approaches are used in the relief of pain caused by intramuscular injection. Shotblocher and acupressure, which are among these methods, are easy to apply.More evidence-based studies are needed to fully understand the effectiveness of acupressure an d shotblocher in reducing pain associated with intramuscular injection.This study will be conducted to compare the effectiveness of shotblocker and acupressure in reducing pain associated with intramuscular injection in the emergency department.

Detailed Description
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Intramuscular injection is a nursing practice that is frequently used in clinical practice. If intramuscular injection is not performed with correct and appropriate methods, it can cause serious complications. These complications include pain, cellulitis, muscle fibrosis and contracture, sterile abscesses, tissue necrosis, granuloma, intravascular injection, hematoma, and nerve injuries. Although it has healing and therapeutic properties, intramuscular injection can cause pain and discomfort in the patient. Intramuscular injection pain develops due to the mechanical trauma caused by the needle entry and the sudden pressure created when the drug is injected into the muscle. Nurses play an active role in eliminating or reducing the pain that occurs in this process. Pharmacological and non-pharmacological methods are used to reduce pain associated with intramuscular injection. Topical anesthetics, one of the pharmacological methods, are limited in use in emergency services due to their slow analgesic effects, risk of systemic toxicity and local side effects. There are various non-pharmacological methods applied to control pain caused by injection. One of the non-pharmacological methods applied to reduce the pain experienced during intramuscular injection is Shotblocker application. It is reported that ShotBlocker reduces pain by temporarily blocking the peripheral nerve endings by preventing the perception of pain and its transmission to the central nervous system. Another method used to reduce pain due to injection is acupressure. Experimental and clinical evidence suggests that acupressure may relieve pain and promote relaxation. In addition, this non-invasive application involves minimal risk and can be easily integrated into the application. Acupressure points such as UB31, UB32, UB33 and UB34 are stated to be beneficial for low back pain, hernia, dysmenorrhea, dysuria, pain. Of these, UB32 and UB31 are clinically frequently used acupressure points. In this study, the UB32 acupressure point will be used to reduce the pain associated with multiple injections.

Official Title
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Comparison of the Efficacy of Shotblocker and Acupressure in Reducing Pain Due to Intramuscular Injection in the Emergency Department: A Single-Blind, Randomized Controlled Study

Conditions
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Acute Pain, İnjection, Acupressure, Alternative Medicine

Intervention / Treatment
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* Other: acupressure application
* Device: Shotblocher


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Those who are admitted to the emergency room for the administration of prescription drugs or those who are planned to be injected intramuscularly by the emergency room physician Diclofenac sodium (75 mg/3 ml) was ordered to the patient in the emergency department. 18 years and older Patients who have not had an injection in the same area in the last 2 week Having no problems with vision and hearing Does not have a disease that can cause loss of sensation and sensory loss Open to communication and cooperation Patients willing to participate in the study will be included in the study. Exclusion Criteria: Those who apply to the emergency department with complaints of anxiety or trauma (soft tissue traumas, multiple traumas due to traffic accidents or falls, or bone fractures), Those who experience a change in consciousness, Patients with clinical conditions that require urgent intervention, Infection at the injection site

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acupressure<br>Before the injection, patients will be asked to lie in the prone position. The acupressure point (UB32) will be located on the side to be injected. The UB32 point is located in the sacrum region, below the medial and posterior superior iliac spine, in the second sacral foramen. The acupressure point UB32 will be pressed circularly with a stopwatch for 1 minute. Then the acupressure point will be pressed three times in sequence with the thumb directly (pressure equal to 4.5 kg/cm2). Diclofenac sodium (75mg/3ml) will be injected after acupressure. | Other: acupressure application<br>* Acupressure will be applied to the UB32 point<br>|
| Experimental: Shotblocher<br>Before the injection, patients will be asked to lie in the prone position. The protruding surface of the Shotblocker will be placed in the area just before the injection so that the point of entry with the needle will not be contaminated. Pressure will be applied by keeping the Shotblocker constant throughout the process. The injector will be quickly inserted through the gap in the middle of the shortblocher. Shotblocker will be removed after drug administration. | Device: Shotblocher<br>* Shotblocher will be administered during injection<br>|
| No Intervention: Control group<br>No intervention will be applied before the injection | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analog scale | The visual analog scale will be used to assess the patient's pain intensity. It is a self-reported scale in the form of a 10-cm ruler indicating no pain at one end and unbearable pain at the other. Accordingly, the patient is told to evaluate his/her pain between 0 and 10, with 0 indicating no pain and 10 indicating unbearable pain | 2 minutes | 
| Verbal category scale | The verbal category scale is a one-dimensional, simple, descriptive scale. Patients are asked to state the most appropriate word to describe their pain while filling in the scale. To describe the severity of pain, the patients had to choose from among (1) mild, (2) disturbing, (3) severe, (4) very severe, and (5) unbearable 5. The verbal category scale is a one-dimensional, simple, descriptive scale. Patients are asked to state the most appropriate word to describe their pain while filling in the scale. To describe the severity of pain, the patients had to choose from among (1) mild, (2) disturbing, (3) severe, (4) very severe, and (5) unbearable | 2 minutes |