Abstract
BackgroundDiagnosis of sacroiliac region pain is supported by a positive response to sacroiliac region analgesia (SIRA). Varying techniques have been described for SIRA; with clinician preference often dictating method. Potential complications following SIRA include ataxia and recumbency. No study has specifically evaluated the prevalence of complications.ObjectivesTo describe the complication prevalence following SIRA in a referral clinic.Study designRetrospective cohort study.MethodsReview of records from horses presented to two of the authors at Rossdales, Newmarket, between January 2014 and December 2018, that underwent SIRA. Injection was performed using a blind midline approach with 20 mL mepivacaine (Intra-Epicaine 20mg/ml; Dechra) infiltrated through a straight 18 gauge 8.9cm spinal needle subdivided into four sub-locations per block.Results118 horses were included, with 167 individual blocks. One horse showed a mild hindlimb gait abnormality following SIRA, which resolved uneventfully over 3 hours; complication rate 1/118 horses (0.85%; 95% CI: 0,2.5%), 1/167 joints (0.60%; 95% CI: 0,1.8%). SIRA subjectively improved lameness/performance in 132/167 (79%) joints. 49/118 (42%) received bilateral SIRA with 53/118 (45%) evaluated ridden following SIRA.Main limitationsSmall population numbers with low complication prevalence rate.ConclusionsSIRA, using the described technique, has a low (0.85%) prevalence of complications.
Highlights
Sacroiliac region pain is a well-reported finding in horses presenting with lameness or poor performance [1,2,3,4]
One horse showed a mild hindlimb gait abnormality following sacroiliac region analgesia (SIRA), which resolved uneventfully over 3 hours; complication rate 1/118 horses (0.85%; 95% CI: 0,2.5%), 1/167 joints (0.60%; 95% CI: 0,1.8%)
Sacroiliac region pain can only be confirmed by a positive response to either diagnostic local analgesia or infiltration of medication [1, 2, 10]
Summary
Sacroiliac region pain is a well-reported finding in horses presenting with lameness or poor performance [1,2,3,4]. Various non-specific provocation techniques are described to identify sacroiliac region pain [5]. Sacroiliac region pain can only be confirmed by a positive response to either diagnostic local analgesia or infiltration of medication [1, 2, 10]. Sacroiliac region pain is commonly seen in combination with other sites of lameness [1, 2]. A previous study by Barstow and Dyson [1] identified hindlimb lameness in 80% of horses which was not caused by but in combination with sacroiliac joint region pain; with 89% of these horses diagnosed with proximal suspensory desmitis [1]. Diagnosis of sacroiliac region pain is supported by a positive response to sacroiliac region analgesia (SIRA).
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