All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .
Liposomal lidocaine to improve procedural success rates and reduce procedural pain among children: a randomized controlled trial
Background : Historically , children have been undertreated for their pain , and they continue to undergo painful cutaneous procedures without analgesics . A new topical anesthetic , liposomal lidocaine 4 % cream ( Maxilene , RGR Pharma , Windsor , Ont . ) , has become available . It has pharmacologic properties that are superior to other topical anesthetics , including an onset of action of only 30 minutes . We sought to determine the success rate of cannulation , analgesic effectiveness , procedure duration and rate of adverse skin reactions when liposomal lidocaine is used before intravenous cannulation of children . Methods : In this double-blind r and omized controlled trial , children aged 1 month to 17 years received liposomal lidocaine or placebo before cannulation . Success on first cannulation attempt was recorded , and , among children 5 years and older , pain was evaluated before and after the attempt by the child , parents and research assistant using a vali date d measure ( Faces Pain Scale-Revised ) . For children younger than 5 years , pain was evaluated by the parents and research assistant only . The total duration of the procedure and adverse skin reactions were also recorded . Results : Baseline characteristics did not differ ( p > 0.05 ) between children who received liposomal lidocaine ( n = 69 ) and those who received placebo ( n = 73 ) . Cannulation on the first attempt was achieved in 74 % of children who received liposomal lidocaine compared with 55 % of those who received placebo ( p = 0.03 ) . Among children 5 years of age and older ( n = 67 ) , lower mean pain scores during cannulation were reported by those receiving liposomal lidocaine ( p = 0.01 ) . Similarly , lower mean pain scores during cannulation were reported by the parents and research assistant for all children who received liposomal lidocaine than for all those who received placebo ( p < 0.001 ) . The mean total procedure duration was shorter with liposomal lidocaine ( 6.7 v. 8.5 minutes ; p = 0.04 ) . The incidence of transient dermal changes was 23 % in both groups ( p = 1.0 ) . Conclusions : Use of liposomal lidocaine was associated with a higher intravenous cannulation success rate , less pain , shorter total procedure time and minor dermal changes among children undergoing cannulation . Its routine use for painful cutaneous procedures should be considered whenever feasible
All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .