A Systematic Review of the Measurement Properties of Face, Legs, Activity, Cry and Consolability Scale for Pediatric Pain Assessment

Abstract

Purpose We performed this systematic review to summarize the psychometric properties of Face, Legs, Activity, Cry and Consolability ( FLACC ) scale in pediatric patients in different settings. Methods Two investigators independently searched PubMed, EMBASE, OVID and China National Knowledge Infrastructure (CNKI) for eligible studies through July 2021. We assessed the psychometric properties using the modified critical appraisal tool (CAT). Finally, we systematically reviewed the results of the included studies. Results A total of 15 studies were eventually included. The overall quality of each eligible study was low to moderate. The FLACC scale has been available in different versions and in different settings. Although eligible studies have demonstrated significant clinical benefit in assessing postoperative pain in pediatric patients aged 0 to 10 years from post-anesthetic care unit (PACU), pediatric intensive care unit (PICU) and inpatient unit, and in assessing procedural pain in pediatric patients aged 0.5 to 7 years from emergency unit, immunization center and PICU, mostly without test-retest analysis. Conclusion Although the absence of a gold standard of pain assessment, the currently available data support the usefulness of the FLACC from the perspective of criterion validity. Therefore, the FLACC scale can be considered for measuring observational pain in infants and children. However, further studies are still needed to provide more robust evidence.

Perioperative analgesic management in patients with bladder exstrophy: A clinical study

“…Postoperative analgesia was assessed by the FLACC scale which is moderately reliable for patients aged between 5 and 16 years. 4 SR Engineer et al found that replacing clonidine in place of epidural fentanyl resulted into comparable analgesia with fewer side effects. Tsui and Charles, showed that ketamine or clonidine to a caudal epidural prolong the duration of block.…”

“…Post-operative pain was assessed using the face, legs, activity, cry, and consolability (FLACC) pain scale (Table 1), and the sedation score was assessed using Ramsay sedation score (Table 2). 4 The surgical procedures done performed included primary bladder closure, anterior abdominal wall closure, pelvic osteotomy, ureteric re-implantation, bladder neck repair, epispadias repair, and vaginal reconstruction.…”

Exploring the Role of Artificial Intelligence in Gauging Pain Severity caused by Local Dental Anesthetic Injections in Children: a cross-sectional study

“…For instance, self-report pain assessment scales such as visual analog scale (VAS) depends on choosing the face that has expressions that highly represent the child's pain perception [11]. In addition, FLACC (Face, Legs, Activity, Cry, Consolability) scale is an objective scale in which facial expressions are taken into consideration while detecting the pain intensity [12].…”