Introduction All newborn acute pain scores require face observation. Using linen protecting from light aggressiveness as well as non-invasive ventilation masks make the face less accessible. The point is to validate FANS scale (Faceless Acute Pain Neonatal Scale) ignoring face survey.

Methodology Prospective multi-centric study. We filmed premature babies (24–40 weeks of gestation) during a painful care (venipuncture). Three observers assessed pain with FANS and a validated score: DAN (Acute Pain of Neonate). The FANS based on movements, screaming and vegetative reactions survey. Reliability study included: inter-observers agreement and internal consistency (Cronbach alpha coefficient). Validity study included: intraclass correlation coefficient (ICC) between the 2 scales. To assess the discriminating ability towards painful and non-painful stimulation, 10 patients were observed (watched ? surveyed ?) during thigh rubbing and during puncture. FANS’score difference between the two situations were studied according to Wilcoxon test.

Results From April 2006 to September 2007, 53 prematures 32 [30–35] weeks and 1500 [1000–2200] g. were observed (watched?). Cronbach alpha coefficient is 0.72. ICC were 0.92 [0.9–0.98] for inter-observer agreement and 0.88 [0.76–0.93] for scales correlation. The scores are significantly higher during the painful events/non painful stimulation: (3 [2–5] vs 1 [0–1], p<0.003).

Conclusion FANS scale seems reliable and valid. It is the very first scale to assess pain when face is inaccessible to survey.