황산스트렙토마이신 근육주사시 혼합용매가 조직손상과 동통에 미치는 영향

Effect of Different Solvents on the Degree of Tissue Damage and Pain by Streptomycin Intramuscular Injection

Streptomycin sulfate is an anti-tuberculous agent, which can be injected intra muscularly. With the increased frequency of its injection, the complication such as pain, discomfort, and damage in nerves, vessels, and iocal tissues is on the rise. In particular, local tissue damage of injection site gives a discomfort continuously to patients by fibrosis, necrosis, delayed healing of the tissue, and decreased absorption of the drug. Eventually the recovery and healing process is delayed. The purpose of this study is to compare tissue damage and pain between when streptomycin is injected in normal saline and when injected in distilled water. Also, correlations between damage and pain in terms of gender, age, walking amount, and total body fat after injection have been explored. The subjects of this study were 13 patients who had been diagnosed of pulmonary tuberculosis and hospitalized at K hospital in K wangju from Jan. 3 to Mar. 3, 1999. Streptomycin was injected once a day on each gluteal area of the subjects alternately. After 12 injections tissue damage and pain on the injected area with streptomycin dissolved in saline were compared to those in distilled water as control. The degree of tissue damage and pain after streptomycin injection were measured by needle EMG and self-reported graphic rating scale. The collected data were analysed by SPSS program. The differences of tissue damage and pain between experimental group and control group were analysed by non-parametric Wilcoxon signed rank test. And pain intensities were shown using Box-Plot. Also, correlations between tissue damage and pain in terms of age, total body fat, and walking amount after injection were analysed by Spearman‘s rho correlation coefficient. The difference of tissue damage and pain according to gender was analysed by non-parametric Wilcoxon rank sum test. The results of this study were summarized as follows; 1. Needle EMG showed that the muscle tissue of experimental group with normal saline less damaged than that of control group with distilled water(Z=-3.464, p= .001). 2. No significant difference was noted in the degree of pain between experimental group and control group(Z=-.312, p=.755). 3. In the variables of age, total body fat, and walking amount after injection, the tissue damage was correlated with age positively( γ =.516, p=.000). 4. In the variables of age, total body fat, and walking amount after injection, the pain was correlated with walking amount in both groups(normal saline: r =-.328 ， p=.003 ; distilled water : r =-.271 , p=.016). 5. No significant difference were noted in the degree of tissue damage (Z=-1.684, p=.092) and pain (Z=- .416, p=.678) according to gender. In conclusion, it is highly recommended that the use of normal saline as a solvent for streptomycin injection to decrease damage of tissue and to promote healing of tissue.