Jakobsen 2012.

Methods	Parallel RCT Ethics committee approval: approved by the Central Denmark Region Committee on Biomedical Research Ethics and the Danish Medicine Agency Informed consents: written informed consents were obtained from all participants Site: Aarhus University Hospital, Skejby, Aarhus, Denmark Setting: university hospital Dates of data collection: unspecified Funding: unspecified Registration: Eudra CT 2005‐000617‐35
Participants	60 participants; mean age: 71.3 years; sex distribution: 21 females and 39 males Inclusion criteria Low‐ to moderate‐risk participants between the ages of 65 and 80 years scheduled for CABG with or without AVR Exclusion criteria Ejection fraction < 0.3 Myocardial infarction within the last 4 weeks Diabetes Severe pulmonary or arterial hypertension Contraindication for TEA No preoperative optimal echocardiographic imaging
Interventions	Intervention Epidural analgesia (N = 30) Comparator Systemic analgesia (N = 30) Induction and maintenance: propofol or sevoflurane, sufentanil, and rocuronium Surgery: CABG, valve procedure, or both with CPB, using a hollow‐fibre membrane oxygenator
Outcomes	Relevant to this review Risk of mortality Risk of myocardial infarction Risk of neurological complication: cerebrovascular accident Time to tracheal extubation Haemodynamic variables Others Rescue analgesics Acute kidney injury: renal function expressed as changes in s‐creatinine: fewer TEA patients (13.3% vs 36.7%; P = 0.074, Chi² test) developed acute kidney injury ICU length of stay (hours from arrival in the ICU to discharge to the surgical ward) Time to eligible to ICU discharge (predefined scoring system evaluated at regular intervals) Hospital length of stay
Notes	Conflict of interest: study authors declare that they have no competing interests Correspondence: email sent 16 March 2018; no reply DOI: 10.1053/j.jvca.2012.05.007 and 10.1053/j.jvca.2012.05.008
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomization by the standard envelope method with blocks of 20 participants was performed immediately before insertion of the epidural catheter the day before surgery
Allocation concealment (selection bias)	Low risk	Randomization by the standard envelope method with blocks of 20 participants was performed immediately before insertion of the epidural catheter the day before surgery
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not reported
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Low risk	Sixty‐three patients were approached; 2 declined, and 1 was excluded because surgery was changed to off‐pump CABG surgery
Selective reporting (reporting bias)	Unclear risk	Quote: "there were no significant differences in blood loss, urine output, administration of crystalloids and adverse events (not shown)"
Other bias	Low risk	Groups well balanced for preoperative characteristics One participant in the TEA group did not receive a functional epidural, but because the protocol was based on an intention‐to‐treat principle, this participant was analysed in the TEA group