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 .
Tramadol drops in children: analgesic efficacy, lack of respiratory effects, and normal recovery times.
Tramadol hydrochloride is a racemic mixture of two enantiomers . It has analgesic activity suitable for mild to moderate pain , part of its analgesic activity being modulated via mu receptors . Adult studies have raised the question of increased electroencephalographic activity . The study examined the analgesic efficacy , respiratory effects , and behavior plus recovery-influencing properties of tramadol in the pediatric patient . Day-case dental extraction children , aged 4 - 7 years having 6 or more extraction s , were studied .  Tramadol drops , 3 mg/kg , plus oral midazolam , 0.5 mg/kg , were administered 30 minutes prior to a sevoflurane in N2O and O2 anesthetic .  Forty children received this premedication treatment ( T ) and 10 entered a  placebo control group  ( P ) , where no tramadol was administered . Entry was r and om , double blind , and parallel . Analgesic efficacy was measured using the Oucher face pain scale ( OFPS ) , with responders scoring three or less . Respiration was measured by rate and oxygen saturation . Behavior and ease of mask induction were assessed on a 4-point scale . Recovery was measured with the Aldrete scale . Parameters were measured from 30 minute preanesthetic to 120 minute postanesthetic . Analgesic efficacy was shown , with an OFPS score of 11.42 ( SD 18.66 ) ( T ) and 29.80 ( SD 25.14 ) ( P ) ( P < .05 ) . Responders on tramadol were 77.5 % versus 0 % on placebo ( P < .05 ) . No respiratory depression was seen ; rates and oxygen saturations were the same preanesthetic and postanesthetic . Similarly , the two groups had no cardiovascular differences . Preanesthetic behavior patterns were the same ( P > .05 ) , with 85 % of the tramadol group being drowsy but awake versus 90 % in the placebo group . Similarly satisfactory induction behavior was seen in 95 % of the tramadol group and 90 % of the placebo group . Recovery times were 48.6 minutes ( SD 32.3 ) ( T ) and 43.1 minutes ( SD 32.5 ) ( P ) ( P > .05 ) . It is concluded that tramadol at 3 mg/kg has no clinical respiratory depressant effect and that behavior and recovery times are unaffected . Analgesic efficacy is demonstrated
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 .