***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The Wong-Baker FACES Pain Rating Scale ( WBS ) , used in children to rate pain severity , has been vali date d outside the emergency department ( ED ) , mostly for chronic pain . The authors vali date d the WBS in children presenting to the ED with pain by identifying a corresponding mean value of the visual analog scale ( VAS ) for each face of the WBS and determined the relationship between the WBS and VAS . The hypothesis was that the pain severity ratings on the WBS would be highly correlated ( Spearman 's rho > 0.80 ) with those on a VAS . METHODS This was a prospect i ve , observational study of children ages 8 - 17 years with pain presenting to a suburban , academic pediatric ED . Children rated their pain severity on a six-item ordinal faces scale ( WBS ) from none to worst and a 100-mm VAS from least to most . Analysis of variance ( ANOVA ) was used to compare mean VAS scores across the six ordinal categories . Spearman 's correlation ( rho ) was used to measure agreement between the continuous and ordinal scales . RESULTS A total of 120 patients were assessed : the median age was 13 years ( interquartile range [ IQR ] = 10 - 15 years ) , 50 % were female , 78 % were white , and six patients ( 5 % ) used a language other than English at home . The most commonly specified locations of pain were extremity ( 37 % ) , abdomen ( 19 % ) , and back/neck ( 11 % ) . The mean VAS increased uniformly across WBS categories in increments of about 17 mm . ANOVA demonstrated significant differences in mean VAS across face groups . Post hoc testing demonstrated that each mean VAS was significantly different from every other mean VAS . Agreement between the WBS and VAS was excellent ( rho = 0.90 ; 95 % confidence interval [ CI ] = 0.86 to 0.93 ) . There was no association between age , sex , or pain location with either pain score . CONCLUSIONS The VAS was found to have an excellent correlation in older children with acute pain in the ED and had a uniformly increasing relationship with WBS . This finding has implication s for research on pain management using the WBS as an assessment tool Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more In a r and omized double-blind study of 57 children ( aged 6 months-6 yr ) , pain following lateral thoracotomy was relieved with repeated i.v . doses of morphine 100 or 50 micrograms kg-1 , or buprenorphine 3.0 or 1.5 micrograms kg-1 . The same drug and dosage were continued and  cardioventilatory indices , pain intensity and sedation measured for an observation period of 24 h. The sums of the pain intensity differences were equal in all groups . The mean doses for the complete initial analgesia were 230 and 180 micrograms kg-1 with the larger and the smaller bolus doses of morphine and 5.8 and 3.7 micrograms kg-1 with buprenorphine , respectively . The mean duration of action of buprenorphine  was slightly but not significantly longer than that of morphine . The total consumption of both morphine and buprenorphine  was less when the smaller bolus doses were used . Two patients developed a degree of ventilatory depression following repeated doses of buprenorphine . Buprenorphine was equal to morphine as a postoperative analgesic This study was a prospect i ve , r and omized comparison of the ventilatory effects of equianalgesic single‐doses of morphine , 100 μg/kg , and buprenorphine , 3.0 μg/kg , administered intravenously to 20 children ( 5–8 years of age ) after elective ophthalmic surgery . The decrease in ventilatory rate and acute change in the arteriolar oxygen saturation and the increase in end‐tidal CO2 levels were statistically significantly greater in magnitude and duration after buprenorphine than after morphine . For both drugs , the time , duration and magnitude of ventilatory changes varied appreciably between individuals . No child had apnea or hypoventilation requiring assistance . The authors conclude that acutely administered buprenorphine  depresses ventilation to a greater degree than morphine . The maximal ventilatory effect of buprenorphine occurs later than with morphine , and ventilatory depression after buprenorphine may develop late . For safety , all children given opioids intravenously should be observed until they are fully responsive and ventilatory control has stabilized The safety and efficacy of buprenorphine and morphine as postoperative analgesicsfor children were compared in 60 boys and girls 4 to 14 years old having elective orthopedic operations on upper or lower extremities . The drugs were given in a double-blind manner initially intravenously and thereafter by sublingual buprenorphine or intramuscular morphine administered as required to relieve pain until the third postoperative morning . The IV dose needed to achieve complete initial analgesia was 5.2 ± 2.8 μg/kg buprenorphine and 166 ± 100 μg/kg morphine . The duration of effect was significantly longer with buprenorphine than with morphine , 248 ± 314 and 114 ± 109 minutes , respectively ( P = 0.03 ) . The most common side effects were nausea and vomiting ( 28 and 16 % ) and urinary retention ( 21 and 19 % ) in the buprenorphine and morphine groups , respectively . Analgesia with sublingual buprenorphine was as effective and reliable as with intramuscular morphine but a longer duration of action could not be demonstrated The study describes long term ventilatory effects of 50 or 100 micrograms.kg-1 of morphine or 1.5 or 3.0 micrograms.kg-1 of buprenorphine when given in repeated intravenous ( i.v . ) doses , in a double blind fashion , to achieve equal levels of analgesia after thoracotomy . The patients were 56 children , six months to six years of age .  Ventilatory rate ( VR ) was measured over the 24 h study period , and arterial carbon dioxide tension ( PaCO2 ) was measured on arrival in the Paediatric Intensive Care Unit ( PICU ) and at 1 , 6 , 12 and 18 h. In the buprenorphine groups VRs progressively decreased during the first 2 h and remained significantly lower ( P < 0.05 ) than in the morphine groups for 7 h. For the rest of the study period there were no differences . The PaCO2 values did not differ significantly at any point . For safety , prolonged observation of children is needed after intravenous administration of buprenorphine to ensure the ventilatory rate has stabilized 
    Output:
    
There was no significant difference in the rates of adverse effects .
Conclusions Buprenorphine provided a longer duration of analgesia than morphine .
This in combination with its unique sublingual preparation could prove particularly advantageous in the paediatric population .