The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study

Abstract

Aims and objectives: The aim of this study is to measure the thickness of the muscles in the dorsogluteal and the ventrogluteal injection sites and to determine which injection site is farther away from the neurovascular structures.

Background: Although the dorsogluteal region is frequently used for intramuscular injections, the ventrogluteal region is suggested as a more secure injection site due to its distance to the neurovascular structures. However, there are no measurements regarding the distances of these structures. Due to this reason, the distance between these injection sites and the neurovascular structures should be measured.

Design: This study is a descriptive study that used cadavers to measure the distance between the injection sites and the neurovascular structures.

Methods: The study was conducted on 29 cadavers fixed with 10% formalin. The needle was advanced until reaching its end point. A 1·5-inch needle was used for the injections in both regions. The gluteal region was dissected. Parameters were measured with a digital vernier calliper. Data Analysis was performed using spss and the Wilcoxon Signed-Rank Test was used to examine differences among measurements from the two injection regions. Data were collected between February and May 2014.

Results: Sum of the thickness of the muscles is greater in the dorsogluteal region. The ventrogluteal region is farther than the dorsogluteal region from neurovascular structures. For the ventrogluteal injection administered from the same side, total thickness of the muscle was 22·22 ± 5 mm, distance to the superior gluteal artery was 13·87 ± 16 mm and distance to the superior gluteal nerve was 11·82 ± 14 mm. For the dorsogluteal injection, total thickness of the muscle was 28·35 ± 7 mm, distance to the superior gluteal artery was 6·83 ± 9 mm, and distance to the superior gluteal nerve was 5·67 ± 9 mm.

Conclusion: Intramuscular injections must be based on an individual clinical assessment of each patient.

Relevance to clinical practice: The ventrogluteal region is preferred as the first-choice injection site. A needle of recommended length should be used to reach the target muscle.

Keywords: cadaver; dorsogluteal; evaluation; gluteal region; injections; muscles; neurovascular structures; nursing; ventrogluteal.