Caputo 2011.

Methods	Parallel RCT Ethics committee: approved by the Central and South Bristol Research Ethics Committee (registration number E5471) Informed consents: written informed consents were obtained Site: Yale School of Medicine, New Haven, CT, USA; and University of Bristol, Bristol, UK; and Clinica Montevergine, Mercogliano, Italy Setting: university hospital Dates of data collection: August 2003 to November 2007 Funding: funded by the British Heart Foundation Registration: unspecified
Participants	226 participants; mean age 65.7 years; sex distribution: 22 females and 204 males Inclusion criteria Adult (≥ 16 years) participants Undergoing non‐emergent off‐pump CABG Exclusion criteria Intravenous heparin, warfarin, or clopidogrel at the time of surgery Suffered from bleeding diathesis
Interventions	Intervention Epidural analgesia (N = 109) Comparator Systemic analgesia (N = 117) Premedication: benzodiazepines Induction: fentanyl, propofol, and pancuronium or vecuronium Maintenance: isoflurane or propofol Surgery: off‐pump CABG
Outcomes	Relevant to this review Risk of mortality Risk of myocardial infarction Risk of pulmonary complications Risk of atrial fibrillation or atrial flutter Risk of neurological complications Pain scores Haemodynamic variables Others Length of hospital stay
Notes	Correspondence: information received from study authors Conflict of interest: none declared DOI: 10.1093/icvts/ivt001
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomized treatment allocations were generated using Stata version 8. Participants were stratified by the consultant team via 1:1 allocation using blocks of varying sizes
Allocation concealment (selection bias)	Low risk	Allocation details were concealed in sequentially numbered, opaque sealed envelopes. These were prepared by the clinical trials and evaluation unit
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "open"
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "open"
Incomplete outcome data (attrition bias) All outcomes	Low risk	All randomized participants were included in the analysis No participants withdrew from the trial
Selective reporting (reporting bias)	Low risk	All results were reported
Other bias	Unclear risk	Intention‐to‐treat Epidural anaesthesia: 18 not performed and 9 failed epidural Systemic analgesia: 3 participants received epidural analgesia Groups had similar demographic characteristics, except that lung disease/chronic obstructive airways disease was more common in the epidural group (23% vs 12%)