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 .
Nitrous oxide analgesia for minor pediatric surgical procedures: an effective alternative to conscious sedation?
BACKGROUND / PURPOSE Minor surgical procedures in children , while usually not requiring general anesthesia , need effective control of pain , anxiety , and motion . Certain techniques of conscious sedation may result in loss of protective airway reflexes . Nitrous oxide , however , when inhaled at levels below 50 % maintains protective reflexes and does not require fasting or postprocedure monitoring . This study prospect ively examines the efficacy of nitrous oxide analgesia in children undergoing outpatient surgical procedures . METHODS Over a 2-year period ( 2000 to 2002 ) , 150 consecutive children were given  nitrous oxide analgesia as an alternative to a general anesthetic , sedation , or local anesthetic alone . Nitrous oxide ( < 50 % ) was administered by our practice 's sedation-certified nurse practitioner without an anesthesiologist present . The children used the Wong-Baker Faces Scale ( 0 - 5 ) to score pain at different intervals ( preprocedure , at injection , during procedure , and postprocedure ) and event memories were tabulated . RESULTS Of 150 children , 5 were uncooperative and could not participate . One hundred forty-five children , ages 1 to 20 years ( Mean , 9.83 + /- 4.92 years ) successfully underwent procedures ( 58 cyst/nevus excisions , 49 abscess drainages , 38 other ) using nitrous . Two patients were too young to score pain . Pre- and postprocedure pain scores were significantly higher in the abscess group ( P < .0001 ) ; during the procedures , however , all groups reported pain scores less than 1 , with parents citing 100 % satisfaction with the technique . Of 128 children receiving local anesthesia , 107 ( 84 % ) had no recall of the injection . Complications were limited to 4 patients ; 2 experienced nausea , and 2 vomited . All resolved without interrupting the procedure . CONCLUSIONS Nitrous oxide analgesia is a cost-effective and efficacious alternative to conscious sedation or general anesthesia for minor pediatric surgical procedures . In the office or outpatient setting , the technique provides for almost pain/anxiety-free surgery , no postoperative monitoring , and a high degree of satisfaction for patients , parents , and staff
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 .