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 .
Needle-Free Powder Lidocaine Delivery System Provides Rapid Effective Analgesia for Venipuncture or Cannulation Pain in Children: Randomized, Double-Blind Comparison of Venipuncture and Venous Cannulation Pain After Fast-Onset Needle-Free Powder Lidocaine or Placebo Treatment Trial
OBJECTIVE . The Comparison of Venipuncture and Venous Cannulation Pain After Fast-Onset Needle-Free Powder Lidocaine or Placebo Treatment trial was a r and omized , single-dose , double-blind , phase 3 study investigating whether a needle-free powder lidocaine delivery system ( a sterile , prefilled , disposable system that delivers lidocaine powder into the epidermis ) produces effective local analgesia within 1 to 3 minutes for venipuncture and peripheral venous cannulation procedures in children . METHODS . Pediatric patients ( 3–18 years of age ) were r and omly assigned to treatment with the needle-free powder lidocaine delivery system ( 0.5 mg of lidocaine and 21 ± 1 bar of pressure ; n = 292 ) or a sham placebo system ( n = 287 ) at the antecubital fossa or the back of the h and 1 to 3 minutes before venipuncture or cannulation . All patients rated the administration comfort of the needle-free systems and the pain of the subsequent venous access procedures with the Wong-Baker Faces Pain Rating Scale ( from 0 to 5 ) . Patients 8 to 18 years of age also provided self-reports with a visual analog scale , and parents provided observational visual analog scale scores for their child 's venous access pain . Safety also was assessed . RESULTS . Immediately after administration , mean Wong-Baker Faces scale scores were 0.54 and 0.24 in the active system and sham placebo system groups , respectively . After venipuncture or cannulation , mean Wong-Baker Faces scale scores were 1.77 ± 0.09 and 2.10 ± 0.09 and mean visual analog scale scores were 22.62 ± 1.80 mm and 31.97 ± 1.82 mm in the active system and sham placebo system groups , respectively . Parents ' assessment s of their child 's procedural pain were also lower in the active system group ( 21.35 ± 1.43 vs 28.67 ± 1.66 ) . Treatment-related adverse events were generally mild and resolved without sequelae . Erythema and petechiae were more frequent in the active system group . CONCLUSIONS . The needle-free powder lidocaine delivery system was well tolerated and produced significant analgesia within 1 to 3 minutes
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 .