Defining the Ideal Injection Techniques When Using 5-mm Needles in Children and Adults

作者：Hofman Paul Leslie^*; Derraik Jose Gulherme Behrensdorf; Pinto Teresa Elizabeth; Tregurtha Sheryl; Faherty Ann; Peart Jane Michele; Drury Paul Leslie; Robinson Elizabeth; Tehranchi Ramin; Donsmark Morten; Cutfield Wayne Stephen

来源：Diabetes Care, 2010, 33(9): 1940-1944.

DOI：10.2337/dc10-0871

OBJECTIVE - We aimed to establish the ideal injection techniques using 5-mm needles to reliably inject insulin into the subcutaneous fat in both children and adults and to quantify the associated pain and leakage of the test medium.
RESEARCH DESIGN AND METHODS - A total of 259 subjects (122 children/adolescents and 137 adults) were injected with sterile air corresponding to 20 IU insulin (200 mu l) with 32-G 5-mm needles at 90 degrees or 45 degrees, in the abdomen and thigh, and with or without a pinched skin fold. Injection depth was assessed via ultrasonography. Subjects rated pain on a visual analog scale. Test medium injections into the abdomen and thigh (0.2-0.6 ml) were also administered to assess injection leakage.
RESULTS - Among children, 5.5% of injections were intramuscular (IM) and 0.5% were intradermal, while in adults, the incidence was 1.3 and 0.6%, respectively. The frequency of IM injections was greater in boys and negligible among adult women. Subcutaneous fat thickness was the primary predictor of the likelihood of IM injections (P < 0.001). A third of all patients reported experiencing no pain during insulin injection, with children/adolescents experiencing considerably more discomfort than adults. Some leakage of medium was observed, but was unrelated to injection volume and was generally minimal.
CONCLUSIONS - 5-mm needles are reliably inserted into subcutaneous fat in both adults and children. These needles were associated with reduced pain and minimal leakage. We recommend an angled injection with a pinched skin fold for children, while in adults, the technique should be left to patient preference.

• 出版日期2010-9