Study designs of evaluations included in the review
Randomised controlled trials (RCTs) with 10 or more participants per treatment group were eligible for inclusion.
Specific interventions included in the review
Studies of systemic opioids, NSAIDs or paracetamol, administered prophylactically or as needed, were eligible for inclusion. In the included studies, the analgesics were administered post-operatively, peri-operatively with or without additional analgesia, or during the late post-operative period. The drugs of interest were given at various doses, by various routes, and were compared with placebo, each other or other analgesics (details were reported). In some studies, other analgesics were co-administered.
Participants included in the review
Eligible participants were children aged 1 to 16 years who were undergoing tonsillectomy or adenotonsillectomy for any indication. No details of the participants in the included studies were reported.
Outcomes assessed in the review
The studies were required to report the incidence or severity of post-operative pain, or need for rescue analgesia. Pain was measured on a variety of different scales and assessed by the patient, an observer or both. Outcomes related to rescue analgesia included the number of patients requiring rescue analgesia, the time to first dose of rescue analgesia, the number of doses of rescue analgesic and the total dose of rescue analgesic. The review also assessed adverse events. Follow-up in most studies ranged from 30 minutes to 24 hours, but five studies had follow-up periods of 2 to 10 days.
How were decisions on the relevance of primary studies made?
One reviewer assessed titles and abstracts retrieved by the literature search. Potentially relevant articles were retrieved as full papers and two independent reviewers assessed these.