Martinez 2007.

Study characteristics
Methods	Study design: parallel‐group randomized controlled trial Sample size: 41 Country: France Setting: secondary care Dates conducted: not reported Postoperative opioid used and delivery: morphine PCA Pain score collection: blinded nurse Concurrent postoperative analgesics: none reported
Participants	Inclusion criteria Total hip arthroplasty General anaesthesia Exclusion criteria Contraindications to parecoxib (including cardiovascular pathology and renal insufficiency) Previous hip surgery Hip trauma Preoperative use of opioid or NSAID within 48 hours before surgery Patients were withdrawn from the study if they withdrew consent during the follow‐up period, developed a complication that required intervention within 24 hours after surgery or required prolonged (> 60 minutes) mechanical ventilation after surgery.
Interventions	Group Pre (22 participants): 40 mg IV parecoxib at induction, placebo at wound closure and 40 mg IV parecoxib at 12 hours Group Post (19 participants): placebo at induction, 40 mg IV parecoxib at wound closure and 40 mg IV parecoxib 12 hours after surgery
Outcomes	Postoperative pain at rest and movement (0‐100 mm VAS 4 hourly for 24 hours) Morphine consumption (mg consumed during 24 hours after surgery) Time to analgesic request (minutes) Morphine side effects (incidence of sedation, urinary retention and nausea or vomiting during 24 hours) Intraoperative bleeding (mL and incidence of transfusion at day 5 after surgery)
Notes	Funding: NIH Grant GM 061655 (Bethesda, MD), the Gheens Foundation (Louisville, KY), the Joseph Drown Foundation (Los Angeles, CA) and the Commonwealth of Kentucky Research Challenge Trust Fund (Louisville, KY). No financial support of Pfizer Declarations of interest: not reported Authors contacted: no Other: pain score data for 24 hours extracted from graph and SD estimated. Time to analgesic request not time‐to‐event
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated. Quote: "computer‐generated codes"
Allocation concealment (selection bias)	Low risk	Quote: "the randomization instructions were stored in sequentially numbered opaque envelopes opened the day of surgery before induction of anesthesia".
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐dummy placebo used. Quote: "...all patients received three IV injections: one with anesthesia induction, a second at wound closure, and a third 12 hours after induction".
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blinded
Incomplete outcome data (attrition bias) All outcomes	High risk	Fourteen exclusions. Quote: "Eleven patients were eliminated from the study: two patients withdrew consent, one required prolonged postoperative mechanical ventilation, two were inadvertently given paracetamol (one of the exclusion criterion), four because of inadequate order of treatment attribution (third injection made instead the second), one had a surgical complication that required intervention, and one because the patient’s data were lost...Two additional patients were eliminated from the study after morphine titration in the PACU".
Selective reporting (reporting bias)	Unclear risk	No protocol or trial registration
Other bias	Low risk	Similar baseline characteristics and no drug company involvement