Effect of aspiration during intramuscular injection on the occurrence of adverse effects in adults: a systematic review protocol.

Objective: The objective of this review is to evaluate the effect of prior aspiration vs no aspiration during intramuscular injection on the occurrence of adverse effects in adult patients.

Introduction: Aspiration is a procedure conducted prior to the administration of intramuscular medications that aims to ensure that the needle tip is inserted in the proper place. Although aspiration is a common procedure, questions have been raised about adverse effects.

Inclusion criteria: This review will consider experimental and observational studies that include or evaluate the occurrence of any adverse effects following intramuscular injection, either with or without prior syringe aspiration, in adult patients. Adverse effects will include local pain, induration, puncture of blood vessels, decreased drug effect, hematoma, or abscess. The review will exclude studies on venipuncture, aspiration biopsies, or other invasive punctures of a diagnostic nature.

Methods: This review will be conducted in accordance with the JBI methodology for systematic reviews of effectiveness. Databases to be searched will include PubMed, Embase, CINAHL, Scopus, LILACS, and Web of Science Core Collection, as well as sources of unpublished/gray literature, with no date or language limitations. Two independent reviewers will conduct study selection, critical appraisal, and data extraction. Studies will, where possible, be pooled in statistical meta-analysis. The grading of the certainty of evidence will be determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Registration number: PROSPERO CRD42021270432.