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 .
Randomised trial of oral morphine for painful episodes of sickle-cell disease in children
BACKGROUND Oral controlled-release morphine can provide effective analgesia through a non-invasive route and may facilitate outpatient management of severe episodes of sickle-cell pain . We compared the clinical efficacy and safety of oral morphine with continuous intravenous morphine in children with severe episodes of sickle-cell pain , by a double-blind , r and omised , parallel-group design . METHODS 56 children aged 5 - 17 years received loading doses of intravenous morphine of up to 0.15 mg/kg , followed by r and omly assigned oral morphine 1.9 mg/kg every 12 h plus intravenous placebo ( saline ) , or intravenous morphine 0.04 mg kg-1 h-1 , plus placebo tablet .  Breakthrough pain was treated with oral , immediate-release morphine 0.4 mg/kg every 2 - 3 h as required . Pain was assessed daily at 0900 h , 1300 h , 1700 h , and 2100 h with a picture face scale , a pictorial scale ( Oucher ) , a behavioural-observational scale ( CHEOPS ) , and by an investigator . FINDINGS 50 children completed the study ( 28 boys , 22 girls ; mean age 11.2 years [ SD 3.5 ] ; mean oral morphine dose 2.99 mg/kg daily [ 0.75 ] ; mean intravenous morphine dose , 0.81 mg/kg daily [ 0.30 ] ) . Mean overall pain scores were similar for oral and intravenous morphine ( CHEOPS , 6.3 [ 1.5 ] vs 6.4 [ 1.4 ] , p = 0.8 ; Oucher , 31.5 [ 25.4 ] vs 39.2 [ 21.7 ] , p = 0.3 ; Faces , 2.2 [ 1.4 ] vs 2.4 [ 1.3 ] , p = 0.6 ; clinical rating , 1.7 [ 0.7 ] vs 1.9 [ 0.5 ] , p = 0.3 ) .  Opioid analgesia  was required for a mean of 4.2 days ( 1.7 ) and 5.4 days ( 2.6 ) , respectively ( p = 0.0591 ) . Pain scores from all scales correlated significantly ( r = 0.5865 - 0.8980 , p = 0.0001 ) . Frequency of rescue analgesia did not differ significantly between the oral and intravenous morphine groups ( 0.7 [ 0.8 ] vs 0.9 [ 0.7 ] doses daily , p = 0.2 ) . Frequency and severity of adverse events did not differ significantly . INTERPRETATION Oral , controlled-release morphine is a reliable , non-invasive alternative to continuous intravenous morphine for the management of painful episodes of sickle-cell disease in children
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 .