Journal of Korean Academy of Nursing

Original Articles

The Effect on Pain of Buzzy^® and ShotBlocker^® during the Administration of Intramuscular Injections to Children: A Randomized Controlled Trial: Birsen Sivri Bilgen, Serap Balcı; J Korean Acad Nurs 2019;49(4):486-494. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.4.486

Abstract Purpose

To investigate the effect of Buzzy^® and ShotBlocker^® on reducing pain induced by intramuscular penicillin injections in children.

Methods

This was a randomized controlled study. A total of 150 Turkish children aged 7~12 years who presented to our pediatric emergency clinic and met the inclusion criteria were recruited. The children were randomly assigned to each group (control=50, Buzzy^®=50, ShotBlocker^®=50). Data were collected using an information form, the State-Trait Anxiety Inventory for Children, Visual Analog Scale, and Faces Pain Scale-Revised.

Results

The children in the control group had significantly higher pain scores during the penicillin injection than the children in the ShotBlocker^® and Buzzy^® groups. The children in the Buzzy^® group had significantly less pain than the children in both the ShotBlocker^® and control groups (p<.001).

Conclusion

Buzzy^® was more effective compared with ShotBlocker^® in this study.

Citations

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Pain Management Nursing.2025;[Epub] CrossRef
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Zeliha Cengiz, Mürşide Zengin, Emriye Hilal Yayan, Elanur Vicnelioğlu
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Buzzing Away Pain: Efficacy of Buzzy® in Reducing Pain During Canakinumab Treatment for Familial Mediterranean Fever
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The effect of Buzzy application on pain and comfort level during heel stick in newborns: a randomized controlled study
Mehmet Bulduk, Nesrullah Ayşin, Veysel Can, Jiyan Tan Ayşin, Yusuf Dilbilir, Emine Kurt Can
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Effectiveness and safety of Buzzy device in needle-related procedures for children under twelve years of age: A systematic review and meta-analysis
Faguang Jin, Xiaofang Wang, Maomao Qi, Wenhua Zhang, Yongfeng Zhang
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Effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection: An open-label randomized controlled study
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Archives de Pédiatrie.2024; 31(2): 148. CrossRef
Utilization of local pressure devices in pain management during injections: scoping review
Jefferson Wildes da Silva Moura, Aline de Souza Bitencourt, Thiago Lopes Silva, Andréia Cristina Feitosa do Carmo, Luciano Marques dos Santos, Patrícia Kuerten Rocha
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Öznur Tiryaki, Dilek Menekşe, Öner Özdemir, Nursan Çınar, Bahri Elmas
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Effects of ShotBlocker® and the Helfer skin tap technique on pain and fear experienced during intramuscular injection among children aged 6–12 years in pediatric emergency units: A randomized controlled trial
Duygu Sönmez Düzkaya, Atiye Karakul, İrem Akoy, Senem Andi
International Emergency Nursing.2024; 76: 101502. CrossRef
The Impact of Cold Spray and Ice Application During Intravenous Access on Pain and Fear in Children Aged 7-15 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial
Elif Günal Çelik, Duygu Sönmez Düzkaya
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Temporal Dynamics of Pain: Examining the Relationship Between Intramuscular Injection Duration and Pain Perception: A Crossover Randomized Controlled Trial
Yusuf Acarlioglu, Leman Senturan, Saleh Salimi
Cureus.2024;[Epub] CrossRef
Effectiveness of ShotBlocker application on reducing the pain of needle-related procedures in children: A systematic review and meta-analysis
Zahide İyi, Ayşegül İşler, Zeynep Özer
Journal of Pediatric Nursing.2024; 78: e438. CrossRef
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Diler AYDIN YILMAZ, Selen ÖZAKAR AKÇA, Havva Nur PELTEK KENDİRCİ
Bezmialem Science.2024; 12(1): 98. CrossRef
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Ferruccio Pelone, Bessie Kwok, Sabahat Ahmed, Yakup Kilic, Syed Ahsan Ali, Nida Ahmed, Mahmood Ahmad, Jonathan JH. Bray, Farhad Shokraneh, Miryan Cassandra, David S. Celermajer, Eloi Marijon, Rui Providencia
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B. Bilgen Sivri, Y.S. Feng, C. Michler, J. Kuemmerle-Deschner, C. Mahler
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Zeynep Yurdakul, Figen Işık Esenay
Journal of Pediatric Nursing.2023; 72: e201. CrossRef
The Effect of Virtual Reality and Buzzy on First Insertion Success, Procedure-Related Fear, Anxiety, and Pain in Children during Intravenous Insertion in the Pediatric Emergency Unit: A Randomized Controlled Trial
Büşra Güliz Yıldırım, Gülçin Özalp Gerçeker
Journal of Emergency Nursing.2023; 49(1): 62. CrossRef
Comparison of pain levels developed during intramuscular injections to laterofemoral and ventrogluteal regions in children: a randomized controlled study
Serap Balci, Birsen Bilgen Sivri
Revista da Associação Médica Brasileira.2023; 69(1): 85. CrossRef
Effects of applications manual pressure and shotblocker to reduce needle-related pain and fear in children with type 1 diabetes mellitus
Burcu Aykanat Girgin, İlknur Göl, Duygu Gözen, Fatma Çarikçi, Heves Kirmizibekmez
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The Effectiveness of the Buzzy Device in Reducing Pain in Children Undergoing Venipuncture
Elisa Simoncini, Giulia Stiaccini, Elena Morelli, Elisa Trentini, Diego G. Peroni, Maria Di Cicco
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The Effect of 3 Methods (Buzzy, ShotBlocker, and DistrACTION Cards) Used While Taking Blood Samples From Children with Pain and Anxiety
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Medical devices, smart drug delivery, wearables and technology for the treatment of Diabetes Mellitus
Daniel A. Domingo-Lopez, Giulia Lattanzi, Lucien H. J. Schreiber, Eimear J. Wallace, Robert Wylie, Janice O'Sullivan, Eimear B. Dolan, Garry P. Duffy
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Özge Şıktaş, Gülzade Uysal
Journal of Nursing Care Quality.2022;[Epub] CrossRef
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Mürşide Zengin, Emriye Hilal Yayan
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The Effect of Helfer Skin Tap Technique and ShotBlocker Application on Pain in Deltoid Muscle Injection
Tuba KARABEY, Şerife KARAGÖZOĞLU
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Minimizing immunization injection pain in children
Emily Jang, Ekaterina Zhimanov, Bridget Parsh
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Shotblocker Use in Emergency Care
Dilek Yildirim, Berna Dinçer
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Janice Selekman, Dawn Lambert
Journal of Pediatric Surgical Nursing.2020; 9(2): 59. CrossRef

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31 Crossref

The Effects of Guided Imagery on Nursing Students Performing Intramuscular Injections: Min Hyun Suk, Suk Yong Kil, Hye Ja Park; Journal of Korean Academy of Nursing 2002;32(6):784-791. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.6.784

Abstract PDF

PURPOSE: The anxiety and stress of nursing students on performance intramuscular injection diminished nursing skill performance. The purpose of this study was to identify the effects of the guided imagery program on anxiety, stress and nursing skill performance of nursing students. METHOD: The study design was time series with a nonequivalent control group pretest- posttest study. The Data were collected from the 30th of Oct. to the 6th of Nov. 2001. The objects of this study were 36 sophomores of university(18 for the experimental group, 18 for the control group). The Instruments used in this study were State Trait Anxiety Inventory developed by Spielberger (1972), Visual Analogue Scale for Stress and Nursing skill performance developed by the researcher. The guided imagery was provided through audiotapes to the subjects for 8 minutes. The pretest was given before the therapy to measure variables for both groups and the posttests were performed after intervention. The data were analyzed by the SAS program using t-test and paired t-test. RESULT: The results of this study are as follows. The level of anxiety of students who received the guided imagery were significantly lower than that of control group. the level of stress had a deeling tendency and the nursing skill performance level was significantly higher than that of control group. CONCLUSION: The guided imagery suggested as an effective nursing intervention did reduce the anxiety and promoted nursing skill performance of nursing students.

Citations

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Differential effects of guided imagery and progressive muscle relaxation on physical and emotional symptoms in nursing students taking initial clinical training: A randomized clinical trial
Hossam Alhawatmeh, Raya Albataineh, Sawsan Abuhammad
Heliyon.2022; 8(10): e11147. CrossRef
The Effects of Guided Imagery on Stress, State Anxiety, Test Anxiety and Core Basic Nursing Skill Performance Score of Undergraduate Nursing Students
Eunyoung Hong, Bo Kim
Journal of Korean Academic Society of Nursing Education.2020; 26(1): 16. CrossRef
Effects of Guided imagery on Stress and Anxiety of Women Receiving in Vitro Fertilization
Choon Hee Bae, Soon Bok Chang, Sue Kim, Inn Soo Kang
Korean Journal of Women Health Nursing.2011; 17(2): 178. CrossRef

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The Effect of Cutaneous Stimulation and distraction on IV Injection Pain of Chemotherapy Patients: Jeong Sook Park; Journal of Korean Academy of Nursing 1998;28(2):303-318. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.2.303

Abstract PDF

Cutaneous stimulation and distraction are independent nursing interventions used in various painful conditions, which I explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation, distraction and combination of cutaneous stimulation and distraction on the reduction of intravenous injection pain levels of chemotherapy patients. Repeated measurement post test research design was used for one group. Fifty-three cancer patients who received intravenous chemotherapy regular in outpatient injection rooms of D medical center and Y medical center in Taegu were studied from June 23, 1997 to July 12, 1997. First the intravenous injection pain level of the control period was measured. Second, the intravenous injection pain level of the experimental period using cutaneous stimulation was measured. Third, the intravenous injection pain level of the experimental period using distraction was measured. Fourth, the intravenous injection pain level of the experimental period using a combination of cutaneous stimulation and distraction was measured. The instruments used for this study were a visual analogue pain scale as subjective pain measurement and an objective pain behavior checklist. Analysis of data was done by use of repeated measure ANOVA, bonferni, t-test, and F-test. The results of this study were summarized as follows : 1) The first hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period. 2) The second hypothesis that the objective pain behavior score of intravenous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<0.5). 3) The third hypothesis that the subjective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was rejected. 4) The fourth hypothesis that the objective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 5) The fifth hypothesis that the subjective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=3.04, p=0.031), Bonferni p<.05). 6) The sixth hypothesis that the objective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bonferni p<.05).

Citations

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Non-pharmacological management of infant and young child procedural pain
Rebecca R Pillai Riddell, Oana Bucsea, Ilana Shiff, Cheryl Chow, Hannah G Gennis, Shaylea Badovinac, Miranda DiLorenzo-Klas, Nicole M Racine, Sara Ahola Kohut, Diana Lisi, Kara Turcotte, Bonnie Stevens, Lindsay S Uman
Cochrane Database of Systematic Reviews.2023;[Epub] CrossRef
Effects of Patient-Selected Music Listening on the Pain and Anxiety of Patients Undergoing Hemodialysis: A Randomized Controlled Trial
SukKyong Kim, HyeonCheol Jeong
Healthcare.2021; 9(11): 1437. CrossRef
Paediatric Pain Medicine: Pain Differences, Recognition and Coping Acute Procedural Pain in Paediatric Emergency Room
Gabija Pancekauskaitė, Lina Jankauskaitė
Medicina.2018; 54(6): 94. CrossRef
Effect of Abdominal Skin Massage and Warming Therapy on the Pain and Anxiety in Breast Cancer Patients who Underwent Hormone Injections
Jin Hee Jun, Youn Ok Lee, Se-Na Lee
Asian Oncology Nursing.2016; 16(4): 226. CrossRef
Effect of Abdominal Massage beforeIn VitroFertilization Injection on Alleviating Pain among Infertile Women
Ja Ock Ku, Young Joo Park, Jeong Wook Kim, Eun Joung Jeon, Jeong Hee Jang, Young Hee Cho, Hwa Yeun Cho, Jum Mi Park, Seung Shin Lee
Korean Journal of Women Health Nursing.2016; 22(2): 78. CrossRef

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Guided Imagery Types on Stress and Performance of an Intramuscular Injection of Nursing Students: Minhyun Suk, Wonoak Oh, Sukyong Kil; Journal of Korean Academy of Nursing 2006;36(6):976-982. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.6.976

Abstract PDF

Purpose

The purpose of this study was to compare the feeling state guided imagery(FSGI) and end state guided imagery(ESGI) on stress and performance of an intramuscular injection of nursing students.

Method

The design was a time series with a nonequivalent control group pretest-posttest study. Data was collected from the 23 rd to the 25th of Nov. 2004. The subjects of this study were 40 female sophomores (21 for the ESGI, 19 for the FSGI). The instruments used in this study were the Visual Analogue Scale for Stress and the Nursing Skill Performance Check-list on Intramuscular Injection developed by the researchers(10 items). Guided imagery was provided through audiotapes for 8 minutes. A pretest was given before applying the guided imagery, posttest 1 was performed after the intervention, posttest 2 was performed before the intramuscular injection and then evaluation of the performance of the intramuscular injection was done. Data was analyzed using t-test, and Repeated Measures ANOVA.

Result

The level of stress for those who received the ESGI and FEGI was not significant and the level of the nursing skill performance for those who received the ESGI was significantly higher than that of students who received the FEGI.

Conclusion

The use of ESGI has an effect on learning psychomotor nursing skills and further research is needed on stress.

Citations

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The use of ultrasonography in education for undergraduate nursing students: A literature review
Eri Kubo, Miu Nagata, Naoki Yoshinaga
Japan Journal of Nursing Science.2024;[Epub] CrossRef
A randomized controlled trial on the effect of music and white noise listening on anxiety and vital signs during intramuscular injection skill learning
Berna Aksoy, Levent Ozturk
Teaching and Learning in Nursing.2024; 19(1): e52. CrossRef
The Effects of Guided Imagery on Stress, State Anxiety, Test Anxiety and Core Basic Nursing Skill Performance Score of Undergraduate Nursing Students
Eunyoung Hong, Bo Kim
Journal of Korean Academic Society of Nursing Education.2020; 26(1): 16. CrossRef
The effect of music listening on the anxiety of nursing students during their first blood draw experience
Serpil Ince, Kıvan Çevik
Nurse Education Today.2017; 52: 10. CrossRef

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Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults: Dong-Won Choi, Kyeong-Yae Sohng, Bum-Soo Kim; J Korean Acad Nurs 2010;40(6):844-851. Published online December 31, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.6.844

Abstract PDF

Purpose

This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT).

Methods

For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m²). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images.

Results

For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT.

Conclusion

The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.

Citations

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Adverse effects of dorsogluteal intramuscular injection versus ventrogluteal intramuscular injection: A systematic review and meta‐analysis
María Teresa Roldán‐Chicano, Javier Rodríguez‐Tello, Raquel Cebrián‐López, James Richard Moore, María del Mar García‐López
Nursing Open.2023; 10(9): 5975. CrossRef
Abdominal skin subcutaneous fat thickness over the gestational period in Korean pregnant women: a descriptive observational study
Moon Sook Hwang
Korean Journal of Women Health Nursing.2021; 27(4): 318. CrossRef
The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes
Kang Hee Sim, Moon Sook Hwang, Sun Young Kim, Hye Mi Lee, Ji Yeun Chang, Moon Kyu Lee
Diabetes & Metabolism Journal.2014; 38(2): 120. CrossRef
The relationship between body mass index, thickness of subcutaneous fat, and the gluteus muscle as the intramuscular injection site
Sakiko Sakamaki, Yuko Yasuhara, Kazushi Motoki, Kensaku Takase, Tetsuya Tanioka, Rozzano Locsin
Health.2013; 05(09): 1443. CrossRef

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Gluteal Subcutaneous Fat Thickness Measured by Computed Tomography as an Estimate of Proper Gluteal Intramuscular Injections in Korean Adults: Gaeul Joo, Kyeong-Yae Sohng; J Korean Acad Nurs 2010;40(2):247-254. Published online April 30, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.2.247

Abstract PDF

Purpose

To study the thickness of gluteal subcutaneous fat (SCF) and propose an adequate length for needle for gluteal intramuscular injections based on computed tomography (CT) measurements.

Methods

The thickness of gluteal SCF were measured and studied for 568 patients who visited a tertiary hospital in Seoul, Korea between January 2007 and February 2009 for routine health screening and who had abdominopelvic CT.

Results

The average thickness of gluteal SCF was 15.92±4.08 mm in males and 24.90±5.47 mm in females. The thickness of gluteal SCF differed significantly according to gender. The gluteal SCF thickness was greater than 20.4 mm for 54 (12.3%) of the 440 male patients and 99 (77.3%) of the 128 female patients.

Conclusion

The most common syringe needle used for gluteal intramuscular injections in Korea is a 23 G, 25.4 mm-needle. The SCF thickness must be less than 20.4 mm in order to reach the dorsogluteal muscles to a depth of at least 5 mm if this 25.4 mm needle is used. In many patients, especially in female patients, the 25.4 mm needles will result in improper intramuscular injections with the injection being into the SCF. Therefore an appropriate needle should be selected by considering the gender and SCF thickness of patients receiving gluteal intramuscular injections.

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Clinical, Cosmetic and Investigational Dermatology.2024; Volume 17: 2097. CrossRef
Analysis of gluteal subcutaneous and muscle thickness in infants and children for application to intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps
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Gurmeet K. S. Singh, Leo Turner, Reena Desai, Mark Jimenez, David J. Handelsman
The Journal of Clinical Endocrinology & Metabolism.2014; 99(7): 2592. CrossRef
The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes
Kang Hee Sim, Moon Sook Hwang, Sun Young Kim, Hye Mi Lee, Ji Yeun Chang, Moon Kyu Lee
Diabetes & Metabolism Journal.2014; 38(2): 120. CrossRef
Prediction of Optimal Gluteal Intramuscular Needle Length by Skinfold Thickness Measurements in Korean Adults
Dong-Won Choi, Kyeong-Yae Sohng, Bum-Soo Kim
Journal of Korean Academy of Nursing.2010; 40(6): 844. CrossRef

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A Comparison of the Effect of Lidocaine or Sodium Bicarbonate Mixed with Rocuronium on Withdrawal Movement, Mean Arterial Pressure and Heart Rate during Rocuronium Injection: Sung Suk Lee, Haesang Yoon; J Korean Acad Nurs 2009;39(2):270-278. Published online April 28, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.2.270

Abstract PDF

Purpose

This study was performed to find out the effects of lidocaine or 8.4% sodium bicarbonate mixed with rocuronium on mean arterial pressure, heart rate and withdrawal movement.

Methods

Data collection was performed from December 15, 2006 through May 31, 2007. Seventy-five patients with American Society Anesthesiologist (ASA) physical status I & II, under general anesthesia, were randomly assigned to 1 of 3 groups: R group (RG) received rocuronium 0.6 mg/kg; RL group (RLG), rocuronium 0.6 mg/kg mixed with 2 mL of 2% lidocaine; RS group (RSG), rocuronium 0.6 mg/kg with the same volume of 8.4% sodium bicarbonate. Mean arterial pressure, heart rate and withdrawal movement were observed from its injection until 5 min after endotracheal intubation.

Results

The incidence of withdrawal movement with its corresponding injections was 72%, 40% and 4% in RG, RLG and RSG, respectively (p<.001). Score of withdrawal movement was the lowest in RSG of all groups (p<.001). While mean arterial pressure (p=.011) in RSG decreased significantly, and heart rate (p=.003) in RG increased more with its injection than before induction of anesthesia.

Conclusion

Administration of the equivalent volume of 8.4% sodium bicarbonate with rocuronium is more effective than that of lidocaine with rocuronium compared with rocuronium only, in preventing withdrawal movement and in stabilizing mean arterial pressure and heart rate.

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Pharmacological and non-pharmacological interventions for reducing rocuronium bromide induced pain on injection in children and adults
Hemanshu Prabhakar, Gyaninder Pal Singh, Zulfiqar Ali, Mani Kalaivani, Martha A Smith
Cochrane Database of Systematic Reviews.2016;[Epub] CrossRef
Pharmacological and non-pharmacological intervention for rocuronium-induced withdrawal movement in the Korean population: a meta-analysis of 41 studies including 4,742 subjects
Geun Joo Choi, Sangseok Lee, Jeoung Hyuk Lee, Seul Gi Park, Hyun Kang
Korean Journal of Anesthesiology.2014; 66(6): 419. CrossRef
Bolus Effective Dose of Ketamine for Preventing Withdrawal Movement on Injection of Rocuronium in Paediatric Patients
SK Min, SY Lee, KS Park, J Yoo, YJ Chae
Journal of International Medical Research.2011; 39(4): 1408. CrossRef

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