• Narges Heshmatifar, Maryam Salari, Mostafa Rad, Tahoura Afshari Saleh, Fateme Borzoee, and Sedighe Rastaghi.
• Department of Nursing, School of Nursing, Sabzevar University of Medical Sciences, Sabzevar, Iran.
• Pain Manag Nurs. 2022 Jun 1; 23 (3): 353-358.

BackgroundPain management is an important part of care provided by nurses.AimsThe present study aimed to investigate the effect of an innovative method named the skin traction, pressure, and rapid muscle release (TPR) on reducing IM injection pain compared with the Z-track injection method DESIGN: This triple-blind clinical trial investigated 63 patients who required Methocarbamol injection.MethodsTwo, 5-cc methocarbamol injections were given to each patient by the two techniques in two of his/her muscles. In the TPR technique, after applying skin traction and imposing deep pressure on the muscle, the needle was inserted at a 90° angle near the skin and the muscle was released rapidly towards the needle. Hence, the needle was embedded in the muscle. However, muscle release was not applied in the Z-track method. The visual analog scale (VAS) was used to measure pain intensity. For data analysis, T-independent and χ2 tests were used.ResultsThe findings showed that the mean pain score in TPR and Z-track methods was 1.68 ± 1.20 and 3.76 ± 1.42, respectively. The difference was statistically significant.ConclusionThe results of this study showed that the innovative method (TPR) can be used as a substitute for the Z-track method to reduce IM injection pain.Copyright © 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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