Has the popular butt needle from childhood disappeared? Why is it no longer popular?

When to choose upper arm and when to choose buttocks?

It hasn’t completely disappeared, just been used less.

Some drugs can only be injected into the muscles, like Streptomycin.

Buttock injections are essentially muscle injections, as shown on the far left in the image below.

There are two commonly used sites for muscle injections: the buttocks and the outer side of the upper arm, followed by the front and outer side of the thigh.

When should you choose the outer side of the upper arm and when should you choose the buttocks?

Generally, for larger doses, choose the buttocks, and for smaller doses, choose the outer side of the upper arm. For example, when getting vaccinated, such as with the COVID-19 vaccine, the medication dose is small and the thickness of the muscle in the upper arm is also “suitable,” making it more convenient, thus the upper arm is mainly chosen for inoculation.

As for the buttocks, the difference is that the muscles in this area are thicker. As long as the site is chosen appropriately and there are no important blood vessels or nerves, it can accommodate more medication and is the most suitable site for muscle injections.

In some movies, when performing first aid, a needle is injected into the leg, which is a muscle injection of adrenaline.

Why is it used less now?

One reason is the risk involved

The most common use of buttock injections is for children, and if done frequently, it can easily cause lumps that are obvious to touch, which is also not good for muscle development.

Another risk is that the muscle layer in children is not very thick. Although there are fewer nerves in the buttocks, there are still important sciatic nerves passing through. If the injection is not performed in the correct direction or there are operational errors, it may touch the sciatic nerve, leading to gluteal muscle spasms or even nerve damage.

The second reason is that it really hurts

This is something we remember vividly from our childhood.

The third reason is that there are alternatives

One is the availability of new drugs. For example, Streptomycin is now used less, and other intravenous medications can be chosen instead.

The other is the method. For example, for fat-soluble vitamin A, it can be administered through muscle injection (a buttock injection) or subcutaneous injection, with the latter being less irritating.

Development and Issues of Antibiotics

There are roughly two types of injections that children receive in their childhood: penicillin and antipyretic drugs.

1. Let’s start with penicillin. It is an antibiotic that kills bacteria.

The invention of penicillin is truly groundbreaking because it is very effective and has minimal toxic side effects.

I have written about the story of penicillin before, and you can find the link at the end of this article.

However, as the saying goes, “The higher the hurdle, the higher the evil.” In the beginning, bacteria were no match for penicillin and were completely eradicated. But bacteria are not defenseless either. They constantly evolve to resist penicillin. To cope with this situation, we have roughly two strategies:

First, we develop new antibiotics. For example, we make modifications and improvements to penicillin to create new forms of it. Some of these new penicillins can be taken orally, like amoxicillin, which we are familiar with. Since it can be taken orally, who would still opt for injections?

Second, we increase the dosage. Nowadays, we sometimes still use penicillin, but the dosage is usually large. It is not uncommon to use millions of units (between ten and twenty vials) in a day. However, for injections in the buttocks, the usual dosage is one vial, which is 800,000 units. This dosage is too small, of course. But when it comes to injections in the buttocks, it is not possible to inject a large amount. Try injecting a bottle of water and see what happens.

The second type is antipyretic drugs.

When we were children, injections often included antipyretic drugs such as Chaihu. Is it necessary?

Absolutely not!

Children can simply take a little bit of Meilin, which has a strawberry flavor and tastes good. It won’t make them cry and it has better effects than injecting Chaihu. So why go for injections?

As for adults, they can take ibuprofen. Isn’t it fragrant?

Finally, regarding the history of penicillin:

1.2 million deaths in a year! The antibiotic problem is severe. What do you think about it?

Muscle injection risks: Pain, blood vessel injection, nerve damage, muscle lump, local infection. IV not recommended.

The buttock injection refers to a muscle injection, targeting the gluteus muscle. Muscle injection is mainly suitable for cases where intravenous injection is not suitable or not possible, when a more rapid therapeutic effect is required compared to subcutaneous injection, and when administering drugs with strong irritation or high dosage.

With this method of administration, the pain may be more obvious. The drug fills the muscle, causing swelling and discomfort. Some people are so reluctant to sit on a chair or even walk after receiving a buttock injection because it is painful. Swelling may also occur for several days. Secondly, although we withdraw the needle during a muscle injection to avoid injecting the drug into the blood vessels, it is still possible for the drug to be unintentionally injected into the bloodstream. This is because the muscles contain abundant blood vessels. If the medication intended for intramuscular injection is injected into a blood vessel, it will result in a sudden and sharp increase in blood drug concentration, causing problems. Thirdly, muscle injection may potentially damage major nerves. There are many nerves distributed within the muscles. If nerve damage occurs, it can lead to serious issues such as muscle spasms. Fourthly, in some cases, the injected muscle may develop lump formation and degeneration, which is difficult to resolve. Fifthly, if the sanitation conditions are not up to standards for intramuscular injection, it may cause local infections, muscle dissolution, and muscle atrophy.

Currently, for the use of medications, oral administration is preferred whenever possible. Many people hope to have a miracle drug that can immediately alleviate their symptoms when they have a cold. However, this is not possible. Hormones can only immediately improve your symptoms, but the recovery from an illness itself is a process. Even if you have a cold, you should not blindly request intravenous fluid therapy. In outpatient departments, hospitals no longer provide intravenous fluid therapy. If you require it, the doctor will need to transfer you to the emergency department to receive it. Intravenous fluid therapy can adjust the drip rate at any time. If there are any adverse drug reactions, we can immediately stop the infusion to avoid causing further harm to the body.

Improved Choices: Safer, more humane treatments; Diverse administration methods; Enhanced patient experience.

Because there are better choices

How many friends, like me, are still afraid of getting shots?

When I was a child, if I got sick, my father would take me to the clinic. It didn’t matter how much I cried, it was useless. While being held down by adults, I could only watch helplessly as the doctor took out a syringe from the metal box and prepared the medicine. And then, calmly walked towards me. As a young child, from my toes to my buttocks, even my hair stood on end. I’m not exaggerating when I say that the hardness of my buttocks before getting a shot was comparable to that of a brick.

The doctor didn’t care about my struggles. After applying alcohol, they would hold the needle and quickly jab it into my buttocks, as if lightning fast, before I could react. Afraid that the needle might break, the doctor didn’t care if my buttocks hurt or not and injected the entire dose of medicine in one go. The only consolation for my injured soul was that after getting a shot, my parents would buy me a can of pear juice, but I had to eat it while sitting on a slanted position. I can assure you that getting a shot in the buttocks can be painful for a whole night.

The reason why getting shots in the buttocks is not popular is because there are safer and more humane treatment options available.

1. “Getting a shot in the buttocks” has disadvantages in terms of safety. There is a risk of hitting the sciatic nerve or breaking the needle when getting a shot in the buttocks. Moreover, because it is administered by intramuscular injection, there can be pain until the medication is fully absorbed. For common self-limiting illnesses such as cold or fever, the symptoms may be similar, but the actual cause can be diverse, such as influenza virus, parainfluenza virus, respiratory syncytial virus, rhinovirus, adenovirus, cytomegalovirus, Epstein-Barr virus, norovirus, HRSV virus, psittacosis, chlamydia, mycoplasma, etc. Antibiotic shots in the buttocks are not a universal solution.

2. There are more diverse methods of administration. Especially for pediatric patients who need medication, there are options such as oral, transdermal patches, nebulization, intravenous injection, and intramuscular injection. Even if it is necessary to use a softer indwelling needle for injection, it still causes less suffering for children compared to a steel needle. Faced with a variety of routes of administration, there is no need to choose the most torturous one.

3. More emphasis on the patient’s diagnosis and treatment experience. When you go to a pediatric hospital, you will find that blood samples are collected by pricking the fingertip, the seats are shaped like small animals, and various medications are made into sweet strawberry-flavored solutions for children. Although children may still be reluctant, this is progress in the field of medicine.

臀肌挛缩的原因与青霉素注射有关。

Gluteal muscle contraction is related to penicillin injection. The contracted gluteal muscles have ruined countless lives!

Many people have bow legs and different running actions because they cannot lift their legs and cross them like normal people, and it is all because of this reason!

The majority of the causes for contracted gluteal muscles are due to injections. Before 2005, it was popular to inject penicillin, also known as “butt injections.” In order to relieve pain, benzyl alcohol was added, which can cause muscle fibrosis, i.e., muscle contraction. However, not everyone who receives injections will experience contraction; it depends on individual constitution.

The Decline of Intramuscular Injections

I have a lot of experience with this. In the past, I was a pharmacist and worked in the emergency pharmacy of a hospital. There were indeed very few intramuscular injections (often referred to as “butt shots” nowadays), but they were not non-existent.

In my memory, when a patient with a high fever of 39 degrees came to the emergency room and was extremely uncomfortable, the nurse would come to us first to get a dose of antipyretic medicine, such as Aminopyrine, to provide temporary relief. Or when there was stomach cramping and pain, they would first administer a dose of painkiller like 6542. There were also some emergency medications that needed to be administered through injections, but other intramuscular injections were less commonly used.

So why are these intramuscular injections becoming increasingly less common nowadays? I think there may be a few reasons for this.

1. Development of oral medications

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First and foremost, with advances in technology, more and more medications can be taken orally to treat diseases. This method is more convenient, safe, and easier to control the dosage. As a result, intramuscular medications are gradually being replaced by oral medications.

2. Fewer medications require intramuscular injections than intravenous injections

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There are significantly fewer medications that require intramuscular injections compared to those that require intravenous injections. This is mainly because intramuscular injections have slower absorption rates and take longer to have a therapeutic effect. Additionally, the absorption and distribution of intramuscular medications can be influenced by local factors such as the injection site and the condition of the muscle tissue.

By 媛的小口袋

3. Safety concerns

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Intramuscular injections may cause adverse reactions such as pain, swelling, and infection. In comparison, oral medications are safer and have fewer side effects.

4. Economic considerations

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Performing intramuscular injections requires the expertise of a nurse or doctor, which can be costly. On the other hand, the production cost of oral medications is lower, making them more affordable.

5. Convenience factor

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Oral medications can be taken anytime, anywhere, while intramuscular injections need to be administered at a hospital or clinic, which is less convenient.

Considering the above reasons, perhaps these “butt shots” are gradually disappearing from the stage of history.

These are the reasons I can think of, but I welcome your additions.

No need for butt injections anymore.

The medicine for treating diseases has two requirements: efficacy (including balanced elimination of side effects) and route of administration.

Take an extreme example. If someone needs continuous intravenous infusion for 24 hours (a real case in phase III clinical trial), this route of administration is inappropriate.

In other words, no matter how good the medicine is, it needs to be able to reach the target site (with sufficient concentration).

The most acceptable route of administration for patients is probably oral (PO): convenient and painless. However, there are two problems with oral administration: whether the drug can withstand degradation in the digestive tract, and whether the digestive tract can absorb it (bioavailability).

To solve the problem of poor absorption (some antibiotics) or degradation (most protein drugs and some organic drugs), other routes of administration must be used.

The most common ones are intramuscular injection (IM) and intravenous injection (IV).

We have all heard of the problems with intravenous injection. On the one hand, it takes a long time, and on the other hand, the level of technology is high, and the quality of equipment and preparations will directly affect many subsequent issues.

Therefore, intramuscular injection is relatively more cost-effective.

In theory, intramuscular injection can be performed in many parts of the body. For example, when we get vaccinated, the most common site is the arm.

But here is a problem. If there are differences in drug purity or nature, and differences in injection techniques, what to do if the injection hits a nerve, blood vessel, or even bone?

When we were young, we often got punished and beaten. Why do people usually get spanked on the buttocks? There are two reasons. One is that the buttocks have thick flesh and are not easily injured. Another reason is that the buttocks are rich in nerves and sensitive to pain.

Therefore, when giving an injection in the buttocks, one must avoid harm and seek benefits. On the one hand, choose the buttocks because there is more muscle and abundant blood vessels for fast absorption. On the other hand, try to avoid nerves during the injection. So usually, after marking a spot on the buttocks, the injection is given in the outer upper quarter.

Butt injections, however, can cause psychological “shyness” and physical pain. Therefore, with the progress in the development of drug formulations, administration through other routes is entirely possible.

In short, the reason why buttock injections are less common is because:

There is no longer a need for them.

The increase of impurities in blood through intravenous injection

Nowadays, it is popular to receive intravenous infusion, which involves large doses and high fees, and people have become accustomed to it. However, direct intravenous injection leads to an increase in impurities in the blood.

The use of intramuscular injection of penicillin in the past was due to its limited solubility and potential life-threatening risks if administered intravenously. However, with the advancement of pharmaceutical processes, semi-synthetic penicillin can now be safely administered intravenously. The thick viscosity of the suspension requires the use of a large gauge needle.

In fact, the most common situation where people come into contact with buttock injections is when they had a fever as children and went to the hospital to receive a penicillin injection.

So why did they use intramuscular injections for penicillin instead of intravenous injections?

One important reason is that the penicillin used at that time was relatively primitive. For example, long-acting benzylpenicillin cannot be dissolved in water at all and can only be prepared as a suspension. Suspensions can only be administered intramuscularly and not intravenously, otherwise there is a risk to life.

Another example is sodium penicillin, which was commonly used in the past. Although it can be intravenously infused, it must be diluted with a large amount of liquid and infused slowly, otherwise it can easily cause various side effects such as central nervous system toxicity. Therefore, intramuscular injections were often chosen.

With the advancement of pharmaceutical technology, a large number of semi-synthetic penicillins have appeared. Because of their solubility and reduced toxicity and side effects, as well as improved efficacy, we can now conveniently and safely administer penicillin antibiotics intravenously.

However, even semi-synthetic penicillins are not easy to prepare as solutions. For example, when you hear nurses rhythmically tapping small medicine bottles in the treatment room, most likely they are preparing the solution for intravenous infusion of piperacillin-tazobactam.

Therefore, nurses often make the following joke:

“Others celebrate their thirtieth birthday with Parameela (brand of wine), but I spend my thirties tapping piperacillin."

Although benzylpenicillin is now rarely used, it still has many uses in the prevention and treatment of rheumatic fever and syphilis.

By the way, the suspension of this medication is very thick. To avoid blocking the needle, an 8-gauge needle is used for injection, making the administration process very comfortable.

If any friends in need of treatment want to give it a try, they can also reminisce about their childhood memories.

快速有效的治疗方法 The Need for Faster and More Effective Treatment Methods

Why should it disappear? Useful things, a shot can cure half of the illness. Take COVID-19, for example, which is a severe illness. You should just directly receive injections and IV drips, and it will be better in a few days. Why bother with taking medicine, and even traditional Chinese medicine at that? It’s just too slow, or even makes the situation worse. It’s like using a water gun on the battlefield. What’s the point? The reason it’s not popular is because of the overuse of antibiotics. Well, common people don’t care about that much, and they definitely don’t have time to register at the hospital and wait in line for expensive, slow treatment. A shot in the buttocks for ten yuan is much more convenient. The issue of overuse is something for the experts to consider. If antibiotics don’t work in the future, that’s a problem for later. People have enough to worry about in the present.