Noble 1994.

Methods	Study design: 2‐arm parallel randomised trial Conducted in: UK Number of centres: 1 Setting: dental hospital Recruitment period: unclear Funding source: not reported
Participants	Inclusion criteria: 3 to 14 years of age having 1 or more teeth extracted Exclusion criteria: failure to obtain consent and abscess formation Number of participants randomised/evaluated: total = 100 (group 1 = 57 (28 male, 29 female), group 2 = 43 (27 male, 16 female)) Group 1: mean age (years) = 7.1 (SEM = 0.7) Group 2: mean age (years) = 6.5 (SEM = 0.5)
Interventions	Group 1: IFL 3% prilocaine with 0.03 U/ml felypressin infiltration Group 2: NLA
Outcomes	Distress scale Measured at 5 minutes and 30 minutes Visual assessment scale (VAS) measured at 30 minutes
Notes	Induction intravenously with methohexital or inhalation with halothane/nitrous oxide. Maintained with halothane/nitrous oxide Co‐interventions: Children who remained distressed were offered oral acetaminophen oral suspension before discharge Declarations of interest: none reported There was no sample size calculation
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "...were allocated randomly, by the toss of a coin..." Comment: The paper stated the method of sequence generation
Allocation concealment (selection bias)	Unclear risk	The paper did not provide information on allocation concealment
Blinding of participants and personnel (performance bias) All outcomes	Low risk	The study blinded participants. It was unclear whether the study blinded personnel
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "Postoperative assessments for each patient were performed by one of two anaesthesiologists who was unaware of the child's treatment group" Quote: "Global assessment of distress by a blinded observer..." Comment: The study blinded the assessor
Incomplete outcome data (attrition bias) All outcomes	Low risk	The outcome evaluation included all participants
Selective reporting (reporting bias)	Low risk	The study reported all expected outcomes
Other bias	Unclear risk	There were more males than females in the no‐LA group (27 males versus 16 females in the no‐LA group, 28 versus 29 in the GA with LA group)