As with any injection which pierces the skin, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection. This risk is lessened with proper aseptic technique and cleansing of the area prior to administration. Intramuscular injections may also cause an abscess or gangrene at the injection site, depending on the specific medication and amount administered. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection. If single-use or sterilized equipment is not used, there is the risk of transmission of infectious disease between users.
Risks and complications
Intramuscular injection
Intramuscular injection | Risks and complications
No, but, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection. Pain, redness, and swelling or inflammation around the injection site. Intramuscular injections may also cause an abscess or gangrene at the injection site. There is a risk of  infection from bacteria or other organisms and nerve or vascular injury if a nerve or blood vessel. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection.
the three most commonly used sites for intramuscular injections are
user
The deltoid muscle of the upper arm, the gluteal muscle of the buttock, in infants, the vastus lateralis muscle of the thigh
assistant
does this have any complications?
user
Yes, the most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most.
assistant
why is it taken?
user
In medicine, it is one of several methods for parenteral administration of medications.
assistant
is it meant for any specific populations?
user
In some populations, a change in injection site, needle length, or technique is necessary; for  example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle
assistant
which country was it used first?
user
Sorry. I cannot find the answer based on the context.
assistant
can you list some of it's uses?
user
Intramuscular injection is commonly used for medication administration, such as, vaccination
assistant
what technique is used for it?
user
The injection site is first cleaned using an antimicrobial and allowed to dry, it is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees.
assistant
when was it first used?
user
Injections into muscular tissue may have taken place as early as the year 500, but, by 1961 they had "essentially taken over the procedure"
assistant
does it have any side effects?
user
Intramuscular injections began to be used for administration of vaccines for diphtheria in 1923, whooping cough in 1926, and tetanus in 1927. By the 1970s, researchers and instructors began forming guidance on injection site and technique to reduce the risk of injection complications and side effects such as pain. Also in the early 1970s, botulinum toxin began to be injected into muscles to intentionally paralyze them for therapeutic reasons, and later for cosmetic reasons. Until the 2000s, aspiration after inserting the needle was recommended as a safety measure, to ensure the injection was being administered in a muscle and not inadvertently in a vein.
Intramuscular injection | History
However, this is no longer recommended as evidence shows no safety benefit and it lengthens the injection, which causes more pain.
Intramuscular injection | History
Injections into muscular tissue may have taken place as early as the year 500. Beginning in the late 1800s, the procedure began to be described in more detail and techniques began to be developed by physicians practicing at the time. In the early days of intramuscular injections, the procedure was performed almost exclusively by physicians. In the mid 1900s, nurses began preparing equipment and patients for intramuscular injections as part of their delegated duties from physicians, and by 1961 they had "essentially taken over the procedure". To this time, there was not uniform procedures or education for nurses in proper administration of intramuscular injections, and complications from improper injection were common.
Intramuscular injection | History
The area must be cleaned prior to administering the injection, and the injection should be administered in a fast, darting motion to decrease the discomfort to the individual. The volume to be injected in the muscle is usually limited to 2-5 milliliters, depending on injection site. A site should not be chosen which has signs of infection or muscle atrophy. Intramuscular injections should not be used in people with myopathies or clotting problems. Intramuscular injections commonly result in pain, redness, and swelling or inflammation around the injection site. These side effects are generally mild and last no more than a few days at most.
Intramuscular injection | Introduction
Rarely, nerves or blood vessels around the injection site can be damaged, resulting in severe pain or paralysis. If proper technique is not followed, intramuscular injections can result in localized infections such as abscesses and gangrene. While historically aspiration was recommended to prevent inadvertent administration into a vein, it is no longer recommended for most injection sites.
Intramuscular injection | Introduction
As with any injection which pierces the skin, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection. This risk is lessened with proper aseptic technique and cleansing of the area prior to administration. Intramuscular injections may also cause an abscess or gangrene at the injection site, depending on the specific medication and amount administered. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection. If single-use or sterilized equipment is not used, there is the risk of transmission of infectious disease between users.
Intramuscular injection | Risks and complications
Sciatic nerve damage can also affect a person's ability to move their foot on the affected side, and other parts of the body controlled by the nerve. Damage to the sciatic nerve can be prevented by using the ventrogluteal site instead, and by selecting an appropriate size and length of needle for the injection.
Intramuscular injection | Risks and complications
Injections into the deltoid site in the arm can result in unintentional damage to the radial and axillary nerves. In rare cases when not performed properly, the injection may result in shoulder dysfunction. The most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most. The dorsogluteal site of injection is associated with a higher risk of skin and tissue trauma, muscle fibrosis or contracture, haematoma, nerve palsy, paralysis, and infections such as abscesses and gangrene. Furthermore, injection in the gluteal muscle poses a risk for damage to the sciatic nerve, which may cause shooting pain or a sensation of burning.
Intramuscular injection | Risks and complications
The most common side effects from this procedure include itching, rash, nausea, facial flushing/sweating. Some patients experience temporary weight gain due to the steroid. Diabetics may experience an increase in blood sugar. This is a quick and simple procedure, so complications are very rare, but should not be ignored. The risk of complications is decreased when proper aseptic technique is followed, and by the use of the imaging guidance. These complications include an epidural abscess due to infection, temporary increased pain, puncture of the sack containing spinal fluid, excess bleeding, nerve damage, leakage of local anesthetic into the spinal canal, and spondylodiscitis (disc inflammation).
Facet joint injection | Side effects and complications
Intramuscular administration of medication is contraindicated in people with an active infection at the injection site, and those with thrombocytopenia or clotting problems. It is also not recommended in people who are suffering from hypovolemic shock, myopathies, or muscle atrophy, as these may affect the absorption of the medication. Other forms of administration are preferred in people with a myocardial infarction, as the damage to the muscle from an injection may affect tests used in the evaluation thereof.
Intramuscular injection | Contraindications
Side effects following intratumoral injection are limited to flu-like symptoms and resolve within 24 hours. Toxicology studies in New Zealand White rabbits (3 weekly i.v. doses of 10 PFU) showed that JX-594 was well tolerated, and no toxicologically significant effects were observed. There were no overt clinical signs, with the exception of ~5% of body weight loss by day 6 that was followed by a recovery by day 33.
Jennerex | Safety
Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have larger and more numerous blood vessels than subcutaneous tissue, leading to faster absorption than subcutaneous or intradermal injections. Medication administered via intramuscular injection also is not subject to the first-pass metabolism effect which affects oral medications. Common sites for intramuscular injections include the deltoid muscle of the upper arm and the gluteal muscle of the buttock. In infants, the vastus lateralis muscle of the thigh is commonly used.
Intramuscular injection | Introduction
Certain substances, including ketamine, may be injected intramuscularly for recreational purposes. Disadvantages of intramuscular administration include skill and technique required, pain from injection, anxiety or fear (especially in children), and difficult proper self-administration of medications. Vaccines, especially inactivated vaccines, are commonly administered via intramuscular injection. However, it has been estimated that for every vaccine injected intramuscularly, over 20 injections are given to administer drugs or other therapy. This can include medications such as antibiotics, immunoglobulin, and hormones such as testosterone and medroxyprogesterone. In a case of severe allergic reaction, or anaphylaxis, a person may use an epinephrine autoinjector to self-administer epinephrine in the muscle.
Intramuscular injection | Uses
In some populations, a change in injection site, needle length, or technique is necessary. For example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle. For this reason, in these people, a shorter needle is recommended to decrease the risk of injecting too deep. It is also recommended to consider using the anterolateral thigh as an injection site in infants under one year old. To help infants and children cooperate with injection administration, the Advisory Committee on Immunization Practices in the United States recommends using distractions, giving something sweet, and slow lateral swaying.
Intramuscular injection | Special populations
An intramuscular injection can be administered in multiple different muscles of the body. Common sites for IM injection include: deltoid, dorsogluteal, rectus femoris, vastus lateralis and ventrogluteal muscles. Sites that are bruised, tender, red, swollen, inflamed or scarred are generally avoided. The specific medication and amount being administered will influence the decision of the specific muscle chosen for injection. The injection site is first cleaned using an antimicrobial and allowed to dry. The injection is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees. The practitioner will stabilize the needle with one hand while using their other hand to depress the plunger to slowly inject the medication - a rapid injection causes more discomfort.
Intramuscular injection | Technique
Side effects of intravitreal injection can be classified into two categories: drug-related side effects and injection-related side effects. For example, in an intravitreal steroid injection, complications could be divided into steroid-related adverse effects and injection-related adverse effects, in which the former most commonly include cataract formation and increase in intraocular pressure (IOP). Other examples of potential adverse effects are listed as follows: A surgery may be required to treat certain severe complications. Some of the above complications could also lead to blindness, or even loss of the eye (in the case of a severe infection).
Intravitreal injection | Possible Risks and Complications
Injection fibrosis is a complication of intramuscular injection, occurring especially often in infants and children. Injections are often delivered to the quadriceps, triceps, and gluteal muscles, and thus the complication often manifests itself in those muscles. Patients are unable to fully flex the affected muscle. The condition is painless but progressively worsens over time. Orthopedic surgery is the typical treatment.
Injection fibrosis | Introduction
Injections into the skin and soft tissue generally do not cause any permanent damage, and the puncture heals within a few days. However, in some cases, injections can cause long-term adverse effects. Intravenous and intramuscular injections may cause damage to a nerve, leading to palsy or paralysis. Intramuscular injections may cause fibrosis or contracture. Injections also cause localized bleeding, which may lead to a hematoma. Intravenous injections may also cause phlebitis, especially when multiple injections are given in a vein over a short period of time. Infiltration and extravasation may also occur when a medication intended to be injected into a vein is inadvertently injected into surrounding tissues.
Injection (medicine) | Others
Complications from facial autologous muscular injections are very rare. The procedure is minimally invasive and does not require the use of general anesthesia, however, local anesthesia is used to block the patient from feeling pain or discomfort. FAMI procedures are not surgical, it is an outpatient procedure done outside of a hospital. From the 2011 Advanced Techniques in Liposuction and Fat Transfer report, it was noted that in 726 cases over 14 years there were no reports of complications such as cytosteatonecrosis, pseudocyst formation, infections or other issues.
Facial Autologous Muscular Injection | Complications
The needle is withdrawn at the same angle inserted. Gentle pressure may be applied with gauze if bleeding occurs. Pressure or gentle massage of the muscle following injection may reduce the risk of pain. The CDC does not recommend the practice of aspirating for blood to rule out injecting into a blood vessel, as aspiration may increase the risk of pain. There is no evidence that aspiration is useful to increase safety of intramuscular injections when injecting in a site other than the dorsogluteal site.
Intramuscular injection | Technique
Just as cosmetic treatments only last a number of months, paralysis side effects can have the same durations. At least in some cases, these effects are reported to dissipate in the weeks after treatment. Bruising at the site of injection is not a side effect of the toxin, but rather of the mode of administration, and is reported as preventable if the clinician applies pressure to the injection site; when it occurs, it is reported in specific cases to last 7–11 days. When injecting the masseter muscle of the jaw, loss of muscle function can result in a loss or reduction of power to chew solid foods.
Botulinum toxin | Side effects
Subconjunctival hemorrhage, "ptosis" (drooping eyelid) and vertical strabismus are the most common complications, most resolving within several weeks. Ptosis and vertical strabismus are caused by spreading of toxin to adjacent muscles, and their risk decreases with lower doses and more accurate injection techniques. Some "overcorrections", such as "exotropia" (eyes deviated outward) following treatment for infantile esotropia, usually lead to good long-term alignment, and is only an apparent complication. Severe complications, such as globe perforation and retrobulbar hemorrhage are rare. No systemic side effects have been reported in patients treated for strabismus, nor has immunity to botulinum toxin developed, even after multiple injections.
Management of strabismus | Complications
The site is located by dividing the front thigh into thirds vertically and horizontally to form nine squares; the injection is administered in the outer middle square. This site is also the usual site of administration for epinephrine autoinjectors, which are used in the outer thigh, corresponding to the location of the vastus lateralis muscle.
Intramuscular injection | Injection sites
After immunoglobulin therapy's discovery and description in "Pediatrics" in 1952, weekly intramuscular injections of immunoglobulin (IMIg) were the norm until intravenous formulations (IVIg) began to be introduced in the 1980s. During the mid and late 1950s, one-time IMIG injections were a common public health response to outbreaks of polio before the widespread availability of vaccines. Intramuscular injections were extremely poorly tolerated due to their extreme pain and poor efficacy – rarely could intramuscular injections alone raise plasma immunoglobulin levels enough to make a clinically meaningful difference.
Immunoglobulin therapy | 1950s – intramuscular
Common side effects include headache, joint pain, and pain at the site of injection. It may increase the risk of heart attacks, strokes, and deaths from cardiovascular disease.
Romosozumab | Side effects
Rare cases of back pain, neck pain, spinal cord irritation, pneumothorax, and disc injury have been reported at a rate comparable to that of other spinal injection procedures.
Prolotherapy | Side effects
Major side effects are rare. These include loss of vision, stroke, paralysis, or death when the corticosteroids are infected, as in a 2012 meningitis outbreak. Another study found an increased odds of developing epidural lipomatosis, independent of BMI or other factors.
Epidural steroid injection | Side effects
A possible side effect of the monoclonal antibody might be irritation at the injection site. Before the infusions, participants received oral corticosteroids, histamine receptor blockers, and acetaminophen to reduce the risk of infusion-related reactions, which by themselves will cause several side effects.
PCSK9 | Monoclonal antibodies
Intramuscular injection is commonly used for medication administration. Medication administered in the muscle is generally quickly absorbed in the bloodstream, and avoids the first pass metabolism which occurs with oral administration. The medication may not be considered 100% bioavailable as it must still be absorbed from the muscle, which occurs over time. An intramuscular injection can be administered faster and is less invasive than an intravenous infusion, as the site of injection (a muscle versus a vein) is much larger. Medications administered in the muscle may also be administered as depot injections, which provide slow continuing release of medicine over a long period of time.
Intramuscular injection | Uses
Patients may experience pains and aches of the muscles, specifically in areas near the spine. Myalgia side effects can occur up to one or two days after the treatment takes place.
Intravenous iron infusion | Myalgia
People who have previously been vaccinated against rabies do not need to receive the immunoglobulin, only the postexposure vaccinations on days 0 and 3. The side effects of modern cell-based vaccines are similar to the side effects of flu shots. The old nerve-tissue-based vaccination required multiple injections into the abdomen with a large needle but is inexpensive. It is being phased out and replaced by affordable World Health Organization intradermal-vaccination regimens. Intramuscular vaccination should be given into the deltoid, not the gluteal area, which has been associated with vaccination failure due to injection into fat rather than muscle. In children less than a year old, the lateral thigh is recommended.
Rabies | After exposure
As with any interventional procedure, there is a small risk of hemorrhage and/or damage to blood vessels. Pseudoaneurysm can develop at the site of puncture in the femoral artery. During this procedure contrast media is utilized, to which patients may develop an allergic reaction. Symptomatic hypothyroidism may result from the high retained iodine load of the contrast. Off-target delivery of embolic agents such as reflux into healthy surrounding tissue is a potential side effect that may cause complications such as ulceration of the gut or cholecystitis. Specialized techniques and devices may decrease the risk. TACE induces tumor necrosis in more than 50% of patients; the resulting necrosis releases cytokines and other inflammatory mediators into the bloodstream.
Transcatheter arterial chemoembolization | Adverse effects
Systemic side effects include headache, feverishness, fatigue, joint and muscle pain, nausea, arthritis, rash, and abnormal sweating. Injection-site side events include injection-site pain, swelling, and redness.
RVSV-ZEBOV vaccine | Side effects
A major limitation of ERT is that injections are needed routinely, meaning that ERT may not be a permanent cure since it can only improve the patient's muscle strength in the short term. Another constraint is that the enzyme is unable to cross the blood-brain barrier, meaning that ERT is unable to correct the neurological symptoms of the disease. Despite the clear clinical benefits, some side effects from ERT are exhibited. These included mild allergic reactions towards the enzyme, which may snowball into anaphylaxis, a life-threatening allergy. Other side effects are headaches, nausea, vomiting, chest discomfort and abnormal blood pressure.
Autophagic Vacuolar Myopathy | Enzyme Replacement Therapy (ERT)
Although there are risks of infections or other complications, with suitable precautions throughout the injection process, chances for these complications could be lowered.
Intravitreal injection | Introduction
Common side effects include pain, redness and swelling or hardening of the tissues at the injection site. Systemic vaccination reactions commonly include fatigue, flu-like symptoms, a raised temperature between , shivering, headache, dizziness, nausea and a swelling of the inguinal lymph nodes. Symptoms usually subside within days after injection and are less pronounced or absent at subsequent injections.
Lactobacillus vaccine | Side effects
This was initially thought to be an indirect effect of reduced muscle tension, but it is now known that the toxin inhibits release of peripheral nociceptive neurotransmitters, suppressing the central pain processing systems responsible for migraine headache. In 2010, the FDA approved intramuscular botulinum toxin injections for prophylactic treatment of chronic migraine headache.
William J. Binder | Biography
In September 1960, then-Senator John F. Kennedy first visited Jacobson shortly before the 1960 presidential election debates. Jacobson was part of the presidential entourage at the Vienna summit in 1961, where he administered injections to combat severe back pain. Some of the potential side effects included hyperactivity, impaired judgment, nervousness, and wild mood swings. Kennedy, however, was untroubled by Food and Drug Administration reports on the contents of Jacobson’s injections, and proclaimed: "I don’t care if it’s horse piss. It works." Jacobson was used for the most severe bouts of back pain. By May 1962, Jacobson had visited the White House to treat the president thirty-four times, although such treatments were stopped by President Kennedy's White House physicians, who realized the inappropriate use of steroids and amphetamines administered by Jacobson.
Max Jacobson | Treating John F. Kennedy
The two primary complications are injury to the coronary artery and hemorrhage within the pericardium, or tamponade (blood filling the external covering of the heart, called pericardium, causing external pressure on the heart which prevents it from filling). The probability of complications can be reduced by using a narrow gauge of needle. Use of intracardiac injections requires the cessation of cardiopulmonary resuscitation and may be more time-consuming than other delivery methods.
Intracardiac injection | Complications
This protocol made it possible for female athletes to receive high testosterone dosages and still pass doping tests, but it had strong virilizing effects, in particular hirsutism and voice changes. Concomitant consumption of alcohol or contraceptive pills led to severe and sometimes life-threatening liver damage. In male weight lifters cases of gynecomastia had to be resolved by surgery. All these side effects, as well the athletic improvements were meticulously documented in reports to the Stasi. In 2005 some 160 former athletes, facing spiraling medical costs from the long term side effects of anabolic steroids, sued Jenapharm. Some of the female athletes had suffered multiple miscarriages.
Jenapharm | Doping and lawsuits
Complications associated with this block are either ocular or systemic. Local ocular complications include hematoma formation, optic nerve damage and perforation of the globe with possible blindness. Systemic complications include local anesthetic toxicity, brainstem anesthesia, and stimulation of the oculocardiac reflex. Most commonly, patients will report discomfort during the performance of the block, such as the sensation of the needle during insertion and/or pressure behind the eye during injection. In recent years, peribulbar block has become increasingly used because of its lower incidence of complications.
Retrobulbar block | Side effects and complications
When injected into the epidural space or the spine, it may cause serious side effects like loss of vision, stroke, and paralysis.
Betamethasone | Side effects
Overall complication rates have ranged from about 1 to 2 percent since 1979. While somewhat out of favour between 1970 and 1980, the procedure has seen an increase in use due to its relative safety.
External cephalic version | Risks
The most common side effects are droopy eyelids (ptosis) and over- or undercorrections; a further common side effects are diplopia and inadvertent vertical deviation (hypo- or hypertropia). The side effects typically resolve in 3–4 months. Vision-threatening complications are rare, and the intervention is generally considered safe, also when performed repeatedly.
Botulinum toxin therapy of strabismus | Side effects
After injection, a medication may be designed to be released slowly, called a depot injection, which can produce long-lasting effects. An injection necessarily causes a small puncture wound to the body, and thus may cause localized pain or infection. The occurrence of these side effects varies based on injection location, the substance injected, needle gauge, procedure, and individual sensitivity. Rarely, more serious side effects including gangrene, sepsis, and nerve damage may occur. Fear of needles, also called needle phobia, is also common and may result in anxiety and fainting before, during, or after an injection. To prevent the localized pain that occurs with injections the injection site may be numbed or cooled before injection and the person receiving the injection may be distracted by a conversation or similar means.
Injection (medicine) | Introduction
Intramuscular injections, abbreviated as IM, deliver a substance deep into a muscle, where they are quickly absorbed by the blood vessels into systemic circulation. Common injection sites include the deltoid, vastus lateralis, and ventrogluteal muscles. Medical professionals are trained to give IM injections, but people who are not medical professionals can also be trained to administer medications like epinephrine using an autoinjector in an emergency. Some depot injections are also administered intramuscularly, including medroxyprogesterone acetate among others. In addition to medications, most inactivated vaccines, including the influenza vaccine, are given as an IM injection.
Injection (medicine) | Intramuscular injection
Common side effects are constipation, pruritus, muscle spasms, as well as mild and mostly transient reactions at the injection site.
Erenumab | Side effects
Side effects of therapy with oral iron are most often diarrhea or constipation and epigastric abdominal discomfort. Taken after a meal, side effects decrease, but there is an increased risk of interaction with other substances. Side effects are dose-dependent, and the dose may be adjusted. The patient may notice that his/her stools become black. This is completely harmless, but patients must be warned about this to avoid unnecessary concern. When iron supplements are given in a liquid form, teeth may reversibly discolor (this can be avoided through the use of a straw). Intramuscular injection can be painful, and brown discoloration may be noticed.
Iron supplement | Side effects
With extraordinary successes came certain risks and failures. The general risks of the surgery, in addition to standard risks of surgery, include permanent paralysis of the target muscle, recurrence of phantom limb pain, and development of painful neuromas. With the first patient, the ulnar nerve transfer was not successful. The muscle region was not reinnervated as expected, but instead turned bluish after mobilization, possibly due to a congestion of vascular supply. With the left-arm amputation woman mentioned above, her phantom limb pain returned after surgery. Though at a lesser degree and resolved within 4 weeks, it still presented a serious risk because it is unclear whether it will resolve in other future patients.
Targeted reinnervation | Risks and Complications
Disadvantages to the suprascapular nerve block include using two separate needlings, blocking not all of nerves of the shoulder joint, and short duration of action. Some side effects for the procedure include pneumothorax, intravascular injection, and nerve damage. Although this technique provides more pain control compared to placebo, the technique is still inferior to the interscalene block.
Shoulder replacement | Suprascapular with or without Axillary Nerve Blockade Combined with Local Anesthetic Wound Infiltration
Patients are at risk of hypothermia since large amounts of cold fluid are being infused directly into the bloodstream at a rapid rate. This dramatic change in temperature may prompt other side effects such as chest pain, irregular breathing and muscles aches and pains.
Intravenous iron infusion | Hypothermia
Complications of spinal anesthesia can result from the physiologic effects on the nervous system and can also be related to placement technique. Most of the common side effects are minor and are self-resolving or easily treatable while major complications can result in more serious and permanent neurological damage and rarely death. These symptoms can occur immediately after administration of the anesthetic or arise up to 48 hours after surgery. Common and minor complications include: Serious and permanent complications are rare but are usually related to physiologic effects on the cardiovascular system and neurological system or when the injection has been unintentionally at the wrong site.
Spinal anaesthesia | Risks and complications
Serious complications from an MVD include death (0.1%), stroke (1%), hearing loss (3%) and facial weakness (0.5%). Dr. Jannetta has called facial paralysis (as opposed to weakness) a "major and common complication of the MVD." (2 separate depositions under oath: Levy v Jannetta, CCP Allegheny County, GD 81-7689. Other complications include leakage of spinal fluid and wound infection (1%). Most patients will have transient neck pain and stiffness from the surgical incision and from seeding of the spinal fluid with small amounts of blood.
Microvascular decompression | Complications
Alan B. Scott first injected botulinum toxin into extraocular muscles since the early 1970s and published his results 1981, giving rise to a wide scope of clinical research on the use of the toxin. The effect of bupivaine injection on extraocular muscles was first known as causing postsurgical strabismus as a complication of cataract surgery due to the myotoxicity of the local anaesthetic drug bupivaine when inadvertently injected into an extraocular muscle.
Botulinum toxin therapy of strabismus | History
With good binocular vision, the brain mechanism of motor fusion (which aligns the eyes on a target visible to both) helps stabilize the corrected alignment. Strabismus surgery has the undesirable side effect of scarring, which makes frequently needed followup surgeries more difficult, and may generally compromise the eye’s mechanics. Non-surgical injection treatments using various anesthetics, alcohols, enzymes, enzyme blockers, and snake neurotoxins were therefore tried. Finally, inspired by Daniel Drachman’s work with chicks at Johns Hopkins, Dr Scott and colleagues injected botulinum toxin into monkey extraocular muscles. The result was remarkable: a few picograms induced paralysis that was confined to the target muscle, long in duration, and without side-effects.
Alan B. Scott | Botulinum toxin treatment of eye muscles
In a 2008 phase IIa study, 72 patients received 100 µg, 300 µg or placebo in weeks 0, 4, and 12. Blood pressure was lowered dose-dependently, by 5.6 mmHg (systolic) and 2.8 mmHg (diastolic) in the 300 µg group. Morning blood pressure (5:00-8:00) was lowered by 25 mmHg (systolic) and 13 mmHg (diastolic). Side effects were mild and included local reactions, headache and fatigue. The 2008 trial was small and exploratory. It did not address the question of whether the vaccine actually protects internal organs, nor did it address safety concerns such as whether the vaccine would cause autoimmune disease.
CYT006-AngQb | Studies
Prior to this surgery, patients with removed parathyroid glands typically died from muscular tetany.
Parathyroid gland | History
In the video, David states that he sees four fingers when looking at his two pointer fingers. He later adds, "I don't see anything", after which he tells his father: "you have four eyes". David may have experienced well-known, and extraordinarily disturbing, side effects (blurred and double vision) of the dental anaesthesia. In the medical literature, several ocular complications such as diplopia (blurred and double vision) and dizziness have been reported as a consequence of improperly administered local intraoral anaesthesia. It is estimated that ophthalmologic complications occur in approximately 1 in 1,000 local intraoral anesthetic injections; the majority of documented symptomatic responses arise within 5 minutes and may last for several minutes to hours.
David After Dentist | Medical explanation
The ventrogluteal (hip) site is used for injections which require a larger volume to be administered, greater than 1 ml, and for medications which are known to be irritating, viscous, or oily. It is also used to administer narcotic medications, antibiotics, sedatives and anti-emetics. The ventrogluteal site is located in a triangle formed by the anterior superior iliac spine and the iliac crest, and may be located using a hand as a guide. The ventrogluteal site is less painful for injection than other sites such as the deltoid site. The vastus lateralis site is used for infants less than 7 months old and people who are unable to walk or who have loss of muscular tone.
Intramuscular injection | Injection sites
A 28-year follow-up of 740 World War II veterans who had their spleens removed on the battlefield showed a significant increase in the usual death from pneumonia (6 deaths rather than the expected 1.74) and an increase in the deaths from ischemic heart disease (41 deaths rather than the expected 30.26) but not from other conditions.
Splenectomy | Side effects
Potential complications and side effects from the procedure include neck seromas, edema, and surgical site infection.
Hyoid suspension | Hyo-mandibular suspension
Common side effects of the tetanus vaccine include fever, redness, and swelling with soreness or tenderness around the injection site (one of five people have redness or swelling). Body aches and tiredness have been reported following Tdap. Td / Tdap can cause painful swelling of the entire arm in one of 500 people. Tetanus toxoid containing vaccines (DTaP, DTP, Tdap, Td, DT) may cause brachial neuritis at a rate of one out of every 100,000 to 200,000 doses.
Tetanus vaccine | Side effects
They had both used steroids for several years before serious health risks and side effects forced them to stop. After five years of steroid use, Beltzner developed degenerative connective tissue disease and eventually tore the short head of his biceps off the bone. He was subsequently forced to take 12 to 16 months off to recover from this injury.
Brick Bronsky | Partnership with Doug Flex
Reported adverse events are minor and temporary.
Surgery for temporomandibular joint dysfunction | Intra-articular injections
Intravenous formulations began to be approved in the 1980s, which represented a significant improvement over intramuscular objections, as they allowed for a sufficient amount of immunoglobulin to be injected to reach clinical efficacy, although they still had a fairly high rate of adverse effects (though the addition of stabilizing agents reduced this further).
Immunoglobulin therapy | 1980s – intravenous
The medical literature documents cases of ascending paralysis due to massive encephalopathy and spinal nerve demyelination, accompanied by intractable pain, almost uniformly leading to death. Several patients have survived after aggressive and immediate intervention. Rescue treatments consist of washout of the cerebrospinal fluid and administration of protective medications. Children may do better following this injury. One child, who was aggressively treated at the time of the injection, recovered almost completely with only mild neurological deficits. A significant series of inadvertent intrathecal vincristine administration occurred in China in 2007 when batches of cytarabine and methotrexate (both often used intrathecally) manufactured by the company Shanghai Hualian were found to be contaminated with vincristine.
Vincristine | Side effects
Additional premedication may be required in some instances (especially when first getting accustomed to a new dosage), prednisone or another oral steroid. Local side effects of immunoglobulin infusions most frequently include an injection site reaction (reddening of the skin around the injection site), itching, rash, and hives. Less serious systemic side effects to immunoglobulin infusions include an increased heart rate, hyper or hypotension, an increased body temperature, diarrhea, nausea, abdominal pain, vomiting, arthralgia or myalgia, dizziness, headache, fatigue, fever, and pain. Serious side effects of immunoglobulin infusions include chest discomfort or pain, myocardial infarction, tachycardia, hyponatremia, hemolysis, hemolytic anemia, thrombosis, hepatitis, anaphylaxis, backache, aseptic meningitis, acute kidney injury, hypokalemic nephropathy, pulmonary embolism, and transfusion related acute lung injury.
Immunoglobulin therapy | Side effects
Babies are occasionally born without one or both sides of this particular muscle, resulting in a slight droop to the affected side of the face.
Orbicularis oris muscle | Clinical significance
Injections are usually focused on the iliopsoas bursa. Corticosteroid injections are common, but usually only last weeks to months. In addition, corticosteroid side effects can include weight gain, weakening of the surrounding tissues, and even osteoporosis, with regular use. Cellular based therapy may have a role in future injection based treatments, though there is no current research proving the effectiveness of these therapies.
Snapping hip syndrome | Injection based treatments
“Routine botulinum toxin infiltration of the chest wall musculature at the time of mastectomy and immediate reconstruction…would paralyze the muscles and reduce the postoperative pain caused by muscle spasm.”
Lateral pectoral nerve | Clinical significance
The most common side effect is hypersensitivity, which occurs in about 3% of patients. It is associated with symptoms such as cough, shortness of breath, rashes, itching, and angiooedema. Less common side effects include dizziness, headache, nausea, diarrhoea, and reactions at the injection site; they are found in less than 1% of patients.
Imiglucerase | Side effects
Cardiac conduction disturbances are less common, but ECG monitoring while the medicine is injected is advisable and changes quickly reverse after the drug is stopped or the infusion rate is decreased. The drug can be given intramuscularly but is exceedingly painful when given by this route. It can also be given intralesionally when treating cutaneous leishmaniasis (i.e., injected directly into the area of infected skin) and again, this is exceedingly painful and does not give results superior to intravenous administration.
Sodium stibogluconate | Side effects
Injection site reactions are allergic reactions that result in cutaneous necrosis that may occur at sites of medication injection, typically presenting in one of two forms, (1) those associated with intravenous infusion or (2) those related to intramuscular injection. Intra muscular injections may produce a syndrome called livedo dermatitis.
Injection site reaction | Introduction
Michael claims that these injections were excessive and have resulted in permanent loss of function of the left knee.
Clem Michael | Legal action
The 'Semple' vaccine however is known to have side-effects such as paralysis with high risk of other diseases, being just a crude form of churned brain-tissue. It needs administration around the stomach in a series of very painful injections administered over a period of seven to 14 days, a course that many do not complete. Moreover, it is not reliable and the World Health Organization (WHO) has been advocating its total disuse since 1993. (WHO literature )
David Semple | Introduction
While botulinum toxin is generally considered safe in a clinical setting, serious side effects from its use can occur. The use of botulinum toxin A in cerebral palsy children is safe in the upper and lower limb muscles. Most commonly, botulinum toxin can be injected into the wrong muscle group or with time spread from the injection site, causing temporary paralysis of unintended muscles. Side effects from cosmetic use generally result from unintended paralysis of facial muscles. These include partial facial paralysis, muscle weakness, and trouble swallowing. Side effects are not limited to direct paralysis, however, and can also include headaches, flu-like symptoms, and allergic reactions.
Botulinum toxin | Side effects
Additionally, intramuscular injection of polyketals into the leg of rats shows no significant increases in inflammatory cytokines such as IL-6, IL-1ß, TNF-α and IL-12.
Heart nanotechnology | Use in myocardial infarction
Side effects and adverse reactions are rare. Potential side effects or complications could include soreness from the procedure for a few days, trauma to the nerve, which may cause worsening of the pain or loss of nerve function, as well as infection or bleeding complications.
Occipital cryoneurolysis | Introduction
The most common adverse effects are redness and pain at the injection site. Uncommonly, an urticarial reaction can develop about four days after injection. Vaccines produced from mouse brain have a risk of autoimmune neurological complications of around 1 per million vaccinations. However where the vaccine is not produced in mouse brains but in vitro using cell culture there is little adverse effects compared to placebo, the main side effects are headache and myalgia.
Japanese encephalitis | Prevention
To help prevent injection-site reactions, patients are advised to rotate injection sites and use an aseptic injection technique. Injection devices are available to optimize the injection process. Side effects are often onerous enough that many patients ultimately discontinue taking interferons (or glatiramer acetate, a comparable disease-modifying therapy requiring regular injections).
Interferon beta-1a | Side effects
This subcutaneous injection claims to reduce the side effects of DMPA while still maintaining all the same benefits of the original intramuscular DMPA.
Medroxyprogesterone acetate | Available forms
Some patients experience or develop immunoresistance to botulinum toxin type A and must use botulinum toxin type B. Approximately 4% to 17% of patients develop botulinum toxin type A antibodies. The only botulinum toxin type B accessible in the United States is Myobloc. Treatment using botulinum toxin type B is comparable to type A, with an increased frequency of the side effect dry mouth. Common side effects include pain at the injection site (up to 28%), dysphagia due to the spread to adjacent muscles (11% to 40%), dry mouth (up to 33%), fatigue (up to 17%), and weakness of the injected or adjacent muscle (up to 56%).
Spasmodic torticollis | Botulinum toxin
Most of the symptoms last 24–48 hours and are usually relieved by a cold compress and NSAIDS. The numbness should wear off in a few hours.
Facet joint injection | Side effects and complications
This includes potassium, which when administered IV can cause a burning or painful sensation. The incidence of side effects specific to a medication can be affected by the type of access (peripheral versus central), the rate of administration, or the quantity of drug administered. When medications are administered too rapidly through an IV line, a set of vague symptoms such as redness or rash, fever, and others may occur - this is termed an "infusion reaction" and is prevented by decreasing the rate of administration of the medication. When vancomycin is involved, this is commonly termed "Red Man syndrome" after the rapid flushing which occurs after rapid administration.
Intravenous therapy | Pain
In people who are overweight, a 1.5-inch needle may be used to ensure the injection is given below the subcutaneous layer of skin, while a -inch needle may be used for people who weigh under . In any case, the skin does not need to be pinched up prior to injecting when the appropriate length needle is used.
Intramuscular injection | Special populations
The most common serious adverse reactions to avelumab are immune-mediated adverse reactions (pneumonitis, hepatitis, colitis, adrenal insufficiency, hypo- and hyperthyroidism, diabetes mellitus, and nephritis) and life-threatening infusion reactions. Among the 88 patients enrolled in the JAVELIN Merkel 200 trial, the most common adverse reactions were fatigue, musculoskeletal pain, diarrhea, nausea, infusion-related reaction, rash, decreased appetite, and peripheral edema. Serious adverse reactions that occurred in more than one patient in the trial were acute kidney injury, anemia, abdominal pain, ileus, asthenia, and cellulitis. The most common serious risks are immune-mediated, where the body’s immune system attacks healthy cells or organs, such as the lungs (pneumonitis), liver (hepatitis), colon (colitis), hormone-producing glands (endocrinopathies) and kidneys (nephritis).
Avelumab | Side effects
The injection-site reactions can be mitigated by rotating injection sites or by using one of the medications that requires less frequent injections. Side effects are often onerous enough that many patients ultimately discontinue taking Interferons (or glatiramer acetate, a comparable disease-modifying therapies requiring regular injections).
Interferon beta-1b | Side effects
He considered that the risks of amputating the pectoral muscle were outweighed by the otherwise certain outcome of death.
Bernard Peyrilhe | Introduction
The usage of succinylcholine, the depolarizing neuromuscular agent, can lead to hyperkalemia, malignant hyperthermia, myalgia, increased intragastric pressure, increased intraocular pressure, increased intracranial pressure, cardiac dysrhythmias (bradycardia is the most common type) and allergic reactions. As a result, it is contraindicated for patients with susceptibility to malignant hyperthermia, denervating conditions, major burns after 48 hours, and severe hyperkalemia. For nondepolarizing NMBAs except vecuronium, pipecuronium, doxacurium, cisatracurium, rocuronium and rapacuronium, they produce certain extent of cardiovascular effect.Moreover, Tubocurarine can produce hypotension effect while Pancuronium can lead to moderate increase in heart rate and small increase in cardiac output with little or no increase in systemic vascular resistance, which is unique in nondeploarizing NMBAs.
Neuromuscular blocking agents | Side Effects
Infection is typically controlled by administering 1 gram of the antibiotic cefazolin (Ancef) prior to surgery. Excessive blood loss and nerve/artery damage are rare occurrences in surgery and can usually be avoided with proper technique and diligence; however, the patient should be warned of these potential complications, especially in patients with severe injuries and scarring.
Posterolateral corner injuries | Complications
An intracavernous (or intracavernosal) injection is an injection into the base of the penis. This injection site is often used to administer medications to check for or treat erectile dysfunction in adult men (in e.g. combined intracavernous injection and stimulation test). The more common medications administered in this manner include Caverject, Trimix (prostaglandin, papaverine, and phentolamine), Bimix (papaverine and phentolamine), and Quadmix (prostaglandin, papaverine, phentolamine, and either atropine or forskolin). These medications are all types of vasodilators and cause tumescence within 10-15 minutes. Common side effects include priapism, bruising, fibrosis, Peyronies, and pain. Priapism is also often treated with intracavernous injections, usually with sympathomimetic vasoconstricting drugs like adrenaline or phenylephrine.
Intracavernous injection | Introduction
A number of studies of the effects of synephrine in humans, most of them focusing on its cardiovascular properties, have been performed since its introduction as a synthetic drug around 1930. The paper by Stockton and co-workers is representative, describing the effects of racemic synephrine in humans with particular attention to differences resulting from different routes of administration. Thus, it was shown by these investigators that "intramuscular" injections (average effective dose = 200 mg) of the drug produced an increase in systolic blood pressure and pulse rate, without affecting the diastolic pressure. The blood pressure increase reached a maximum (~25 mmHg) in 5 minutes following the injection, then gradually returned to normal over the course of 1 hour.
Synephrine | Effects in humans
While intravenous injection showed, for the same animals, large volumes of pleural and pericardial volumes as well as lung edema.
PR toxin | Effects on animals
Tetanus toxoid containing vaccines (Td, DT, DTP and DTaP) may cause brachial neuritis at a rate of 0.5 to 1 case per 100,000 toxoid recipients.
Diphtheria vaccine | Side effects
Injection-site reaction is common. More rarely, patients can experience joint swelling, joint pain, carpal tunnel syndrome, and an increased risk of diabetes. In some cases, the patient can produce an immune response against GH. GH may also be a risk factor for Hodgkin's lymphoma. One survey of adults that had been treated with replacement cadaver GH (which has not been used anywhere in the world since 1985) during childhood showed a mildly increased incidence of colon cancer and prostate cancer, but linkage with the GH treatment was not established.
Growth hormone | Side effects
Contraindications: malignant hyperthermia, denervating conditions, major burns after 48 hours and severe hyperkalemia Hyperkalemia, malignant hyperthermia, myalgias, increased intragastric pressure, increased intraocular pressure, increased intracranial pressure, cardiac dysrhythmias and allergic reactions
Neuromuscular blocking agents | Adverse effects of succinylcholine
Patients who are allergic to or sensitive to medications, contrast dyes, local anesthesia, iodine, or latex should not have this procedure. Potential risks are infections at the puncture site where the radiopaque substance and/or air are injected. Bleeding is also a small risk. Rarely, nephrogenic systemic fibrosis (NSF) can occur in patients with impaired renal function who receive gadolinium, a debilitating and potentially fatal disease affecting skin, muscle, and internal organs.
Arthrogram | Risks
Vancomycin is usually given intravenously, as an infusion, and can cause tissue necrosis and phlebitis at the injection site if given too rapidly. Pain at site of injection is indeed a common adverse event. One of the side-effects is red man syndrome, an idiosyncratic reaction to bolus caused by histamine release. Some other side-effects of vancomycin are nephrotoxicity including kidney failure and interstitial nephritis, blood disorders including neutropenia, and deafness, which is reversible once therapy has stopped. Over 90% of the dose is excreted in the urine, therefore there is a risk of accumulation in patients with renal impairment, so therapeutic drug monitoring (TDM) is recommended.
Glycopeptide antibiotic | Administration
This depolarization initially triggers fasciculation of skeletal muscle. As a result of prolonged depolarization, endogenous acetylcholine released from the presynaptic membrane of the motor neuron does not produce any additional change in membrane potential after binding to its receptor on the myocyte. Flaccid paralysis of skeletal muscles develops within 1 minute. In normal subjects, skeletal muscle function returns to normal approximately 5 minutes after a single bolus injection of succinylcholine as it passively diffuses away from the neuromuscular junction. Pseudocholinesterase deficiency can result in higher levels of intact succinylcholine molecules reaching receptors in the neuromuscular junction, causing the duration of paralytic effect to continue for as long as 8 hours.
Butyrylcholinesterase | Clinical significance
The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. They also have essentially 100% bioavailability and can be used for drugs that are poorly absorbed or ineffective when they are given orally. Some medications, such as certain antipsychotics, can be administered as long-acting intramuscular injections. Ongoing IV infusions can be used to deliver continuous medication or fluids. Disadvantages of injections include potential pain or discomfort for the patient and the requirement of trained staff using aseptic techniques for administration.
Route of administration | Parenteral