Caruselli 2005.

Methods	Randomized controlled trial
Participants	N = 36; paediatric; ASA 1; average age 5 yrs; 23 male, 13 female; emergency surgery for trauma to arm / elbow; Italian study
Interventions	Infraclavicular block (Raj 1973). Localization method:surface landmarks ‐ intersection of clavicle and line between Chassignac's tubercle and the axillary arterial pulsation. Endpoint for injection: motor response to neurostimulation at 0.3‐0.5mA. Single injection through needle. Modified parascalene block (Dalens 1987). Localization method: surface landmarks ‐ junction of lower third and upper two thirds of a line between Chassignaac's tubercle and the midpoint of the clavicle. End point for injection: motor response to neurostimulation at 0.3‐0.5mA. Single injection through needle. Injectate in both blocks: ropivacaine 2.7 mg/kg in volume of 0.5 ml/kg Sedation for block: oral midazolam 0.3mg/kg 30 minutes prior to block, and IV midazolam 0.1mg/kg, ketamine 1 mg/kg, propofol 1 mg/kg just before block Intraoperative sedation: none
Outcomes	Block quality, defined as A = no sign of discomfort, complete motor block; B = required systemic IV analgesics; C = required general anaesthesia, and assessed 15 min after block completion Complications (unspecified)
Notes	Block quality A was taken as equivalent to the definition of surgical anaesthesia. Block success was assessed at 15 min, earlier than in other studies (30 or 60 min). This may have reduced success rates. Given that complications were unspecified, but that 1 case of Horner's syndrome was reported, data was only entered for the Horner's syndrome.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No mention of the method of random sequence generation
Allocation concealment (selection bias)	Low risk	Quote: " progressively numbered closed envelopes"
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No mention of blinding of patients or outcome assessors in text
Incomplete outcome data (attrition bias) All outcomes	Low risk	Complete follow‐up for all patients
Selective reporting (reporting bias)	Low risk	All pre‐specified outcomes reported
Other bias	Unclear risk	Timing for measurement of outcomes may have been inappropriate ‐ 15 minutes is too short a time for assessment of block efficacy in the reviewers' opinion