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 .
Topical lignocaine for pain relief in acute otitis media: results of a double-blind placebo-controlled randomised trial
Objective : Acute otitis media ( AOM ) is common in children , yet the optimal management of ear pain associated with AOM has not been well studied . We set out to determine the efficacy of topical aqueous 2 % lignocaine eardrops compared with a placebo ( saline ) for pain relief of AOM in children . Design : Double-blind , r and omised , placebo-controlled trial . Setting : Tertiary children ’s hospital emergency department . Patients and interventions : Children aged between 3 and 17 years with earache and AOM without evidence of perforation were eligible . Patients were r and omised to receive either 2 % lignocaine or saline eardrops ( placebo ) . Main outcome measures : Pain scores were measured before and after ear-drop administration . Patient and physician-interpreted pain scores were measured by using the Bieri faces pain scale and visual analogue scale at 10 , 20 and 30 minutes . The primary outcome measure was reduction in patient-measured pain scores by 50 % from the baseline . Secondary outcome measures were reduction in patient- measured pain scores by 25 % or by at least two points . Telephone follow-up occurred after 1 day and 1 week . Analysis was by intention to treat . Results : 63 children ( 31 were treated with lignocaine , 32 with placebo ) aged 3 to 12 years were enrolled . The groups were demographically and clinical ly similar , with similar proportions having received analgesia in the preceding 4 hours . Children receiving lignocaine showed significantly lower patient-measured pain scores with a reduction by 50 % from baseline at 10 minutes ( RR 2.06 , 95 % CI 1.03–4.11 , p = 0.03 ) and 30 minutes ( RR 1.44 , 95 % CI 1.07–1.93 , p = 0.009 ) but not at 20 minutes ( RR 1.35 95 % CI 0.88–2.06 ) . The response to lignocaine treatment showed significantly lower patient-measured pain scores for 25 % reduction at all time points and for two-point reduction at 10 minutes and favoured lignocaine at 20 minutes and 30 minutes without reaching statistical significance . There were no serious adverse events during the 30 minute follow-up period . Conclusion : This study suggests that topical aqueous 2 % lignocaine eardrops provide rapid relief for many young children presenting with ear pain attributed to AOM . The concurrent use of simple oral analgesia is a likely contributor to effective management of this painful childhood condition
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 .