A smartphone version of the Faces Pain Scale-Revised and the Color Analog Scale for postoperative pain assessment in children.
BACKGROUND
Effective pain assessment is essential during postoperative recovery. Extensive validation data are published supporting the Faces Pain Scale-Revised (FPS-R) and the Color Analog Scale (CAS) in children. Panda is a smartphone-based application containing electronic versions of these scales.


OBJECTIVE
To evaluate agreement between Panda and original paper/plastic versions of the FPS-R and CAS and to determine children's preference for either Panda or original versions of these scales.


METHODS
ASA I-III children, 4-18 years, undergoing surgery were assessed using both Panda and original versions of either the FPS-R or CAS. Pain assessments were conducted within 10 min of waking from anesthesia and 30 min later.


RESULTS
Sixty-two participants, median (range) age 7.5 (4-12) years, participated in the FPS-R trial; Panda scores correlated strongly with the original scores at both time points (Pearson's r > 0.93) with limits of agreement within clinical significance (80% CI). Sixty-six participants, age 13 (5-18) years, participated in the CAS trial. Panda scores correlated strongly with the original scores at both time points (Pearson's r > 0.87); mean pain scores were higher (up to +0.47 out of 10) with Panda than with the original tool, representing a small systematic bias, but limits of agreement were within clinical significance. Most participants who expressed a preference preferred Panda over the original tool (81% of FPS-R, 76% of CAS participants).


CONCLUSIONS
The Panda smartphone application can be used in lieu of the original FPS-R and CAS for assessment of pain in children. Children's preference for Panda may translate to improved cooperation with self-report of pain.
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Terri
T
Sun
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Nicholas
N
West
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
J Mark
JM
Ansermino
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Carolyne J
CJ
Montgomery
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Dorothy
D
Myers
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Dustin
D
Dunsmuir
Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.|Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Gillian R
GR
Lauder
Departments of Psychology and Pediatrics, University of Saskatchewan, Saskatoon, SK, Canada.|Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Carl L
CL
von Baeyer
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D000556:Ambulatory Surgical Procedures; D018592:Cross-Over Studies; D005149:Facial Expression; D063731:Mobile Applications; D010147:Pain Measurement / Q000295:instrumentation; D010149:Postoperative Pain / Q000175:diagnosis; D015203:Reproducibility of Results; D012146:Rest; D000068997:Smartphone
adolescent; child; pain measurement/methods; pain measurement/standards; self-report/standards