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 .
Paediatric cancer pain management using the WHO analgesic ladder--results of a prospective analysis from 2265 treatment days during a quality improvement study.
OBJECTIVE To collect data on pain management in paediatric oncology with respect to the WHO ladder approach . SETTING , DESIGN , PATIENTS AND METHODS : Eight German tertiary care paediatric oncology centres prospect ively documented all their in-patient pain treatment courses from June 1999 to December 2000 .  Pain was scored using a 1 - 6 faces scale . RESULTS Two hundred and twenty four patients ( median age , 9 years ; range 0.2 - 32.1 ) were enrolled . Three hundred and thirty three pain episodes comprising a total of 2265 treatment days were documented . Pain was mostly therapy associated . The most frequently administered non-opioid analgesics were dipyrone and paracetamol . On WHO step 2 , tramadol was almost the only opioid used . During tramadol monotherapy average daily pain scores were lower than with a combination of tramadol and non-opioid analgesics . On WHO step 3 ,  morphine  was at least part of the analgesic regimen on most treatment days . Strong opioids were combined with a non-opioid analgesic on 41 % of the treatment days . The mean intravenous morphine equivalence dose was 0.034 mg/kg/h . During opioid and non-opioid combination therapy , adverse effects were more frequent , and average pain scored higher than on opioid monotherapy . CONCLUSIONS WHO- guidelines were closely followed in Germany and seem to provide effective analgesia for children with cancer pain . In our patient group there is no evidence that a combination of an opioid with a non-opioid is more effective than opioid therapy alone in in-patient paediatric oncology pain treatment
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 .