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 .
Pain and Distress from Bone Marrow Aspirations and Lumbar Punctures
OBJECTIVE To compare the efficacy of 3 different pharmacologic regimens to relieve pain and distress in children with cancer undergoing bone marrow aspirations ( BMAs ) and lumbar punctures ( LPs ) . DESIGN Retrospective cohort study with crossovers for some patients . PATIENTS AND METHODS The pain and distress ratings of patients undergoing BMAs ( n = 73 ) and LPs ( n = 105 ) were examined in a comparison of 3 different interventions : ( 1 ) a topical eutectic mixture of lidocaine and prilocaine ( EMLA cream ) , ( 2 ) oral midazolam and EMLA cream , or ( 3 ) propofol/fentanyl general anesthesia . The choice of the intervention depended on patient/parent request . A vali date d faces pain scale was completed by the child or parent following each BMA or LP . The faces pain scale includes ratings of the severity of pain ( from 0 = none to 5 = severe ) and ratings of how frightened ( from 0 = not scared to 5 = scared ) the child was prior to each procedure . Comparisons of the pain and distress ratings were made among all patients for their first procedure and also within individual patients who had received > 1 of the 3 interventions . Independent comparisons between the first treatments received by each patient were analyzed using Kruskal – Wallis tests . Comparisons of different crossover treatments received by individual patients were analyzed using Wilcoxon tests . RESULTS For all first procedures , mean ± SD pain and distress ratings during LPs were significantly lower when propofol/fentanyl was used ( n = 43 ; 0.4 ± 1.0 and 1.4 ± 1.7 ) versus either EMLA ( n = 29 ; 2.4 ± 1.7 and 2.9 ± 1.9 ) or midazolam/EMLA ( n = 33 ; 2.4 ± 1.8 and 2.7 ± 1.8 ) , respectively . Pain and distress ratings during BMAs were also significantly lower with propofol/fentanyl ( n = 29 ; 0.5 ± 1.0 and 1.2 ± 1.7 ) versus EMLA ( n = 21 ; 3.5 ± 1.6 and 3.3 ± 1.8 ) or midazolam/EMLA ( n = 23 ; 3.3 ± 1.5 and 3.0 ± 1.9 ) , respectively . When data were analyzed within each patient , these differences were also present . CONCLUSIONS Children receiving propofol/fentanyl general anesthesia experienced significantly less procedure-related pain and distress than did those receiving either EMLA or oral midazolam/EMLA
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 .