TPR versus Z-track to reduce pain and drug leakage with ventrogluteal intramuscular injections

Effects of TPR Technique and Z Technique on Pain and Drug Leakage in Intramuscular Injections

Not applicable Interventional Cumhuriyet University · NCT07004166

This trial tests whether the TPR or Z-track injection technique causes less pain and less medicine leakage for people aged 16–40 receiving intramuscular diclofenac.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment76 (estimated)
Ages18 Years to 40 Years
SexAll
SponsorCumhuriyet University Academic / other
Locations2 sites (Sivas and 1 other locations)
Trial IDNCT07004166 on ClinicalTrials.gov

What this trial studies

This randomized, triple-blind trial compares the TPR (traction-pressure-release) and Z-track techniques during ventrogluteal intramuscular diclofenac injections in 76 participants aged 16–40. Each participant receives injections using both techniques on randomly assigned ventrogluteal sites, with all injections given by the same nurse and outcomes assessed by blinded evaluators. Pain is measured with a Visual Analog Scale (VAS) and drug leakage is quantified using millimetric paper and a ruler. The trial aims to determine whether TPR offers a quicker, less painful, and lower-leakage alternative to the established Z-track method.

Who should consider this trial

Good fit: Ideal candidates are people aged 16–40 who are prescribed intramuscular diclofenac, have no communication impairments, and have healthy ventrogluteal muscles without sensory issues.

Not a fit: Patients outside the 16–40 age range, those not receiving intramuscular diclofenac, or those with wounds, inflammation, neuropathy, recent injections, or extreme BMI (<15 or >35) are unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, this could reduce injection pain and medication leakage, improving patient comfort and adherence while offering a simple, low-cost technique for clinicians.

How similar studies have performed: The Z-track method is well-established to reduce leakage, while TPR is a newer technique with some promising pain-reduction data but limited prior research on drug leakage.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Aged 16-40
* Prescribed diclofenac sodium
* No communication impairments
* Healthy ventrogluteal muscles without sensory issues

Exclusion Criteria:

* Wounds, redness, bruising, tenderness, or stiffness at the injection site
* Injection in the past 2 weeks
* Neuropathy or other medical conditions
* BMI below 15 or above 35

Where this trial is running

Sivas and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Muscle PainInjection Site PainIntramuscular InjectionDrug Leakage lPainZ-TrackTPR Techniques
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.