Bosenberg A, Thomas J, Lopez T, Kokinsky E, Larsson L E
Department of Anaesthesia, University of Cape Town, South Africa.
Paediatr Anaesth. 2003 Oct;13(8):708-13. doi: 10.1046/j.1460-9592.2003.01142.x.
The faces pain scales are often used for self-report assessment of paediatric pain. The aim of this study was to evaluate the validity of a six-graded faces pain scale after surgery by comparing the level of agreement between the children's report of faces pain scores and experienced nurses' assessment of pain by observation of behaviour. The faces pain scores before, at and after administration of analgesics were analysed. The study was performed in two South African hospitals, one with a mainly rural population and the other with an urban population.
A total of 110 children aged 4-12 years, scheduled for inguinal surgery in the two South African hospitals, were included in the study. The anaesthetic technique was standardized. All patients received a caudal block preoperatively. Postoperative pain assessments were made every hour for 8 h after the caudal block was performed. A designated nurse assessed pain by using a four-graded descriptive scale (no, mild, moderate or severe pain) and thereafter the child reported pain by using the six-graded faces pain scale.
A high correlation was found between the two methods of assessment (tau = 0.76, P < 0.0001). The correlation between methods was high in both hospital populations and in all age groups. The weakest correlation was found in children aged 8-12 years (tau = 0.56, P < 0.01). Significantly lower faces pain scores were found after administration of analgesics compared with pain rating before analgesics (P < 0.0001). The proportion of patients with pain scores above 2 decreased from 86% to 31% (P < 0.001).
The findings support this six-graded faces pain scale as a useful and valid instrument for measuring pain in the postoperative period in children aged 4-12 years.
面部疼痛量表常用于小儿疼痛的自我报告评估。本研究的目的是通过比较儿童报告的面部疼痛评分与经验丰富的护士通过观察行为对疼痛的评估之间的一致性水平，来评估一种六级面部疼痛量表在术后的有效性。分析了给予镇痛药之前、之时及之后的面部疼痛评分。该研究在南非的两家医院进行，一家主要服务农村人口，另一家服务城市人口。
共有110名4至12岁计划在南非这两家医院接受腹股沟手术的儿童纳入本研究。麻醉技术标准化。所有患者术前均接受骶管阻滞。在进行骶管阻滞后8小时内，每小时进行一次术后疼痛评估。一名指定护士使用四级描述性量表（无、轻度、中度或重度疼痛）评估疼痛，然后儿童使用六级面部疼痛量表报告疼痛。
发现两种评估方法之间存在高度相关性（tau = 0.76，P < 0.0001）。在两个医院人群以及所有年龄组中，两种方法之间的相关性都很高。在8至12岁儿童中发现的相关性最弱（tau = 0.56，P < 0.01）。与给予镇痛药之前的疼痛评分相比，给予镇痛药后发现面部疼痛评分显著降低（P < 0.0001）。疼痛评分高于2分的患者比例从86%降至31%（P < 0.001）。
研究结果支持这种六级面部疼痛量表作为测量4至12岁儿童术后疼痛的一种有用且有效的工具。
