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 .
Safety and efficacy of patient controlled epidural analgesia following pediatric spinal surgery.
BACKGROUND Patient controlled epidural analgesia ( PCEA ) is uncommon in pediatric anesthesia . Because PCEA offers superior pain control compared with continuous epidural infusions in adults , we prospect ively evaluated the analgesia efficacy and safety of PCEA in children and adolescents following extensive spinal surgery . METHODS Following ethics committee approval , 100 consecutive children [ age median ( range ) 14 ( 6 - 19 ) years ] undergoing spinal surgery were studied until the seventh postoperative day , and 98 children received a PCEA .  One or two epidural catheters were positioned under direct vision by the surgeon based on the number of vertebral segments operated upon . The epidural solution consisted of bupivacaine 0.0625 % , fentanyl 1 microg.ml(-1 ) and clonidine 0.6 microg.ml(-1 ) , delivered at a basal rate of 0.2 ml.kg(-1).h(-1 ) and a PCEA dose of 0.1 ml.kg(-1).h(-1)(max . 2 h(-1 ) ) . On the fourth postoperative day , PCEA was stopped and analgesia was continued with patient controlled analgesia ( PCA ) with morphine . RESULTS During the PCEA regimen , the maximal scores of the revized facial scale were below 4 at rest with a very high satisfaction rate ( > 90 % ) . Pain scores were higher during mobilization on the first postoperative day and when PCEA was switched to PCA . The overall incidence of adverse events was low and consisted primarily of technical problems and postoperative nausea and vomiting . Only two children experienced a complication requiring the discontinuation of the PCEA but there were no consequent adverse sequelae . CONCLUSIONS The present study demonstrates that PCEA provides excellent pain relief following extensive spinal surgery and is associated with a low incidence of adverse events . The use of PCEA should be encouraged in children and adolescents following extensive spinal surgery
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 .