Adverse reactions of intramuscular injections associated with injection site selection: a literature review
DOI:
https://doi.org/10.12923/pielxxiw-2026-0013Keywords:
safety, application, technique, side effects, intramuscular injectionAbstract
ADVERSE REACTIONS OF INTRAMUSCULAR INJECTIONS ASSOCIATED WITH INJECTION SITE SELECTION: A LITERATURE REVIEW
Introduction. This article aims to determine the adverse reactions associated with the application of intramuscular injections at various injection sites.
Aim. Our study is the literature review with a systematic search strategy. It includes 11 studies from selected databases, including Web of Science, PubMed, and OVID, between October and November 2024. The search was limited to dates between 2019-2024 and the availability of full texts.
Material and methods. Studies often agree that it is important to pay attention to proper application methods and to choose the most suitable injection site based on the condition of the patient, while also addressing the preferences of the medical staff. Some studies differed regarding intramuscular injections (IM) into the ventrogluteal or dorsogluteal area due to the presence of the sciatic nerve.
Conclusions. Intramuscular injections (IMI) are one of the most widely used methods of injecting active substances to a patients. Although this variant of injection is considered very safe, it does carry certain risks. There are several adverse events associated with IM injections, ranging from local events, such as pain, hematoma or redness at the injection site, to more serious events, which include nerve or bone injury and abscess formation. Therefore,, it is important that IM injections are administered carefully and with careful site choice.
References
1. Gulnar E, Ordu Y, Bayram SB, et al. Gluteal muscle and subcutaneous tissue thicknesses in adults: a systematic review and meta-analysis. J. Res. Nurs. 2023;28(3):181-196. https://doi.org/10.1177/17449871231155769
2. Kim Y, Nam Y, Kim D, et al. Evaluating the effectiveness of gluteal intramuscular injection sites: a cadaveric study. Anat. Cell. Biol. 2022;55(1):48-54. https://doi.org/10.5115/acb.21.223
3. Roldán-Chicano MT, Rodríguez-Tello J, Cebrián-Lópezoldán R, et al. Adverse effects of dorsogluteal intramuscular injection versus ventrogluteal intramuscular injection: A systematic review and meta-analysis. Nurs. Open. 2023;10(9):5975-5988. https://doi.org/10.1002/nop2.1902
4. Yalcin Atar N, Deniz Altan M, Kaymaz E, et al. Examining the safety of dorsogluteal and ventrogluteal sites for intramuscular injection in older adults. Int. J. Older People Nurs. 2024;19(6):e12655. https://doi.org/10.1111/opn.12655
5. WORLD HEALTH ORGANIZATION, 2015. WHO vyzývá k celosvětovému používání „chytrých“ injekčních stříkaček [online]. [cit. 2025-1-22]. Dostupné z: https://www.who.int/news/item/23-02-2015-who-calls-for-worldwide-use-of-smart-syringes https://doi:10.1371/journal.pone.0099677
6. Hemingway S, Lui S, White J, et al. Considering skin-to-muscle depth for successful intramuscular injections in an increasingly obese population. Br. J. Nurs. 2023;32(13):628-635. https://doi.org/10.12968/bjon.2023.32.13.628
7. Strohfus P, Palma S, Wallace CH, et al. Dorsogluteal intramuscular injection depth needed to reach muscle tissue according to body mass index and gender: A systematic review. J. Clin. Nurs. 2021;31(19-20):2943-2958. https://doi.org/10.1111/jocn.16126
8. Surraj S, Chandrupatla M, Kusneniwar G, et al. Determination of safe sites of intramuscular arm injections and its relevance to the community. J. Family Med. Prim. Care. 2022;11(10):6101-6106. https://doi.org/10.4103/jfmpc.jfmpc_792_22
9. Silva AMO, Santos RCS, Araujo MGS, et al. Intramuscular injection safety without aspiration in the ventro-gluteal region during vaccination: randomized clinical trial. Rev. Bras. Enferm. 2022;75(1):e20201119. https://doi.org/10.1590/0034-7167-2020-1119
10. Kilroy G, Lorbiecki M, Hagle M, et al. Supporting the safe use of the dorsogluteal intramuscular injection site: an evidence-based quality improvement project. Open Nurs. 2023;30(4):819-827. https://doi.org/10.1177/10783903231178556
11. Ayinde O, Hayward RS, Ross JDC, et al. The effect of intramuscular injection technique on injection associated pain; a systematic review and meta-analysis. PLOS ONE. 2021;16(5):e0250883. https://doi.org/10.1371/journal.pone.0250883
12. Sahebkar M, Khosrojerdi A, Mostafa R, et al. Evaluation of the effect of selecting gluteal injection site on the pain injection based on anthropometric indices and body shape pattern: A randomised controlled trial study. J. Clin. Nurs. 2021;30(11¬12):1556-1563. https://doi.org/10.1111/jocn.15703
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Copyright (c) 2026 Eliška Vaníčková, Valérie Tóthová, Sylva Bártlová (Autor)

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