Comparing Pain of the First-generation Long-Acting Antipsychotic Injections among Three Different IM Techniques

Aim and objectives: To determine the optimal technique to prevent leakage and pain from LAIs, the study compared three types of intramuscular injection techniques: (a) Airbubble technique, (b) Z-track method, and (c) a combination of the air-bubble technique and Z-track method. Background: Long-acting antipsychotic injections (LAIs) are often injected through the muscle, allowing the medication to be slowly absorbed through it. Past literature yields inconclusive results in how to minimize the leakage and pain experienced at the injection site. Design: This experimental study had a within-subjects design. Methods: A total of 144 patients who received the firstgeneration LAIs were purposively sampled from a psychiatry hospital. All participants experienced the three types of injection methods over a 3-month period. They were all asked to rate their level of pain using the numerical rating scale, and after each injection, medical personnel rated the level of medication leakage at the injection site. Results: No significant differences were found in the leakage level between the air-bubble technique, Z-track method, and the combination of the two (F=0.53, p>0.05). Pain level also showed no significant difference between the three types of injection methods during pre-injection (F=0.68 p>.05), 5 minutes post-injection (F=0.87, p>0.05), and 30 minutes post-injection (F=0.97, p>0.05). Conclusion: During the injection of long-acting antipsychotic medication, we suggest consulting the guidance of a clinical injection expert. Choosing an injection method that is most familiar to the nursing staff would allow the minimization of medication leakage and pain at the injection site. Relevance to clinical practice: Nurses should make sure the guidance of a clinical injection expert and verify knowledge of the IM injection skill. Choosing correct injection site and process that can effectively experience of pain and leakage at the injection site.