Breen et al modified the Bromage scale for grading motor block associated with epidural anesthesia. This can help monitor women receiving an epidural block prior to delivery. The authors are from Beth Israel Hospital in Boston.
Parameters:
(1) ability to perform a partial knee bend
(2) hip flexor strength while supine
(3) knee flexion
(4) ability to move feet
Partial Knee Bend
Able to Flex Hip (Supine)
Able to Flex Knees
Able to Move Feet
Scale
Yes
Yes
Yes
Yes
6
weak
Yes
Yes
Yes
5
No
weak
Yes
Yes
4
No
No
weak
Yes
3
No
No
No
weak
2
No
No
No
No
1 (complete)
where:
• Since the authors talk about patients ambulating with an epidural catheter in place, my assumption is that a score of 6 is done with the person standing.
• Note that a high grade in the Bromage scale corresponds to a low score in this modified scale.
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