Stang 1997.

Methods	Prospective, randomized, double‐blind, placebo‐controlled trial Painful intervention: circumcision Study location: Fairview Riverside Medical Center, Minneapolis, Minnesota, USA Study period: 1993 to 1994
Participants	80 healthy term male newborns, mean PMA 39.5 weeks, mean PNA 31.5 h
Interventions	DPNB with non‐buffered lidocaine (0.8 mL lidocaine, 0.2 mL saline), new padded restraint chair and pacifier dipped in water (n = 20) DPNB with buffered lidocaine (0.8 mL lidocaine, 0.2 mL sodium bicarbonate), rigid plastic restraint chair and pacifier dipped in water (n = 20) DPNB with non‐buffered lidocaine (0.8 mL lidocaine, 0.2 mL saline), rigid plastic restraint chair and pacifier dipped in 24% sucrose (n = 20) DPNB with non‐buffered lidocaine (0.8 mL lidocaine, 0.2 mL saline), rigid plastic restraint chair and pacifier dipped in water (n = 20)
Outcomes	Behavioural Distress Scale (scores prior to injection, at injection for DPNB, 2 min post injection, 4 min post injection and at circumcision); plasma cortisol level (30 min after start of circumcision); percentage of sleep during circumcision
Notes	Results were reported as mean and SDs ANOVA with repeated measures were used to compare distress scores. 1‐way ANOVAs were used to examine plasma cortisol and sleep data Adverse effects were not evaluated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Sequence generation not described
Allocation concealment (selection bias)	Unclear risk	Allocation concealment not described
Blinding (performance bias and detection bias) All outcomes	Low risk	Sucrose and water solutions blinded
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blinding of outcome assessments
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Data results did not specify number of infants with data
Selective reporting (reporting bias)	Unclear risk	The study protocol was not available to us so we could not judge whether there were any deviations from it
Other bias	Low risk	Appears free of other bias