A comparison of visual analog scale and Wong Baker facial pain scale for pain measurement in post lower caesarean section case

Neena Gupta, Sachidanand Gupta, Apurva Agarwal, Shaily Agarwal, Rita Mahto


Background: There is various pain measurement tools commonly used to measure pain intensity. However, no single standard exists for quantifying pain in post caesarean section. In our study, we have divided two groups according to use of pain scales and found one scale is more useful than the other in the post caesarean cases.

Methods: The study has been conducted in upper India Sugar Exchange Maternity Hospital department of obstetrics and gynaecology, GSVM Medical College, Kanpur for the duration of 18 months starting from February 2014 to August 2015 on 100 women who were operated for lower caesarean section (LSCS) under spinal anesthesia. Women were divided into two groups according to pain scales visual analog scale (VAS) and Wong Baker facial pain scale (WBFPS). All these selected women were studied in details with regards to clinical history, general examination and local examination. Women from respective group were asked to rate their pain intensity on these pain scales. SPSS was used to analyze the data statistically.

Results: Using analysis of variance, we found that there is significant relationship within the groups having different parameters at different time interval at different probability level. There is a mutual relationship between the groups at different probability level.

Conclusions: The study shows that VAS is the most sensitive and reliable tool to measure post LSCS pain as compared to WBFPS and minimum consumption of rescue analgesia in VAS group to maintain minimum pain score to keep the patient pain free.


Pain, Lower caesarean section, Visual analog scale, Wong baker facial pain scale

Full Text:



Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure pain practice. 2003;3(4):310-6.

Diamond B. Legal aspects of pain management. Salisbury. Quay Books; 2002.

Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005;14(7):798-804.

Karlström R. Engström-Olofsson K. Norbergh M. Sjöling, Hildingsson I. Postoperative pain after cesarean birth affects breastfeeding and infant care. Journal of Obstetric Gynecologic and Neonatal Nursing. 2007;36(5):430-40.

Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine. 2001;8(12):1153-7.

Jaywant SS, Pai AV. A comparative study of pain measurement scales in acute burn patients. Indian Journal of Occupational Therapy. 2003;XXXV:3.

Bashir MS, Khade A, Borkar P, Saleem M, Lingaswamy V, Reddy D. A comparative study between different pain rating Scales in patients with osteoarthritis. Indian J Physiol Pharmacol. 2013;57(2):205-8.

Waldenström U, Borg IM, Olsson B, Sköld M, Wall S. The childbirth experience: a study of 295 new mothers. Birth. 1996;23:144-53.