Pickering 2002.

Methods	Randomized, parallel group trial
Participants	103 children for elective tonsillectomy or adenotonsillectomy ASA I‐II Age 3‐15 years (mean 7.0, 7.0) Sex distribution: M/F (21/19, 7/11) Country: UK
Interventions	Rofecixib 0.625 mg/kg preoperatively Ibuprofen 5 mg/kg preoperatively Placebo preoperatively
Outcomes	Need for early postoperative analgesia Interoperative blood loss Time to first postoperative analgesia Pain scores Analgesic consumption in the first 24hrs Vomiting and antiemetic use Incidence of primary and secondary haemorrhage
Notes	Study had three groups. Data from the ibuprofen and placebo groups used in the review. Recruitment to placebo group finished early due to increased need for analgesics in this group.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer generated random number table
Allocation concealment (selection bias)	Unclear risk	Hospital pharmacist allocated children randomly to groups. But no further details on this
Baseline Imbalances All outcomes	Low risk	Demographic details comparable and no large differences in surgery types between groups. However, recruitment to placebo group finished early
Blinding of participants and personnel (performance bias) 1. Perioperative bleeding requiring surgical intervention	Unclear risk	Patients and investigators blinded to group assignment. No mention of whether surgeon, anaesthetist or nurses blinded
Blinding of participants and personnel (performance bias) 2.Perioperative bleeding requiring non‐surgical intervention	Unclear risk	Patients and investigators blinded to group assignment. No mention of whether surgeon, anaesthetist or nurses blinded
Blinding of participants and personnel (performance bias) 3. Vomiting	Unclear risk	Patients and investigators blinded to group assignment. No mention of whether surgeon, anaesthetist or nurses blinded
Blinding of outcome assessment (detection bias) 1. Perioperative bleeding requiring surgical intervention	Unclear risk	Not clear who "investigators" are and whether they are assessing outcomes or not
Blinding of outcome assessment (detection bias) 2. Perioperative bleeding requiring non‐surgical intervention	Unclear risk	Not clear who "investigators" are and whether they are assessing outcomes or not
Blinding of outcome assessment (detection bias) 3. Vomiting	Unclear risk	Not clear who "investigators" are and whether they are assessing outcomes or not
Incomplete outcome data (attrition bias) All outcomes	Low risk	Three exclusions: one patient from placebo group given diclofenac during surgery; two patients from ibuprofen group ‐ one given diclofenac during surgery and one was too young. Small number of missing patients (5%) unlikely to affect results
Selective reporting (reporting bias)	Low risk	All expected outcomes reported
Other bias All outcomes	High risk	Rescue analgesics used in both groups is same as intervention drug