El‐Refai 2003.

Methods	RCT Approved by the ethics committee and informed consent obtained Setting: Egypt Funding: unspecified
Participants	30 ASA 1 or 2 women undergoing total abdominal hysterectomy Exclusion criteria were history of hepatic or renal disease, myocardial infarction within the previous 6 months and general anaesthesia within the previous 3 months
Interventions	Treatment group: lumbar (L3‐L4 or L4‐L5) epidural with 3 mL of 2% lidocaine as a test dose followed by 9 mL of 0.25% bupivacaine for a sensory level at T10, and 5 mL every hour thereafter (n = 15) Control group: IV patient‐controlled analgesia with morphine (n = 15) General anaesthesia for all participants
Outcomes	Pain at 30 minutes after surgery: 1.4 ± 1.3 vs 2.4 ± 1.4
Notes	No outcomes of interest measured at our selected time points
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"randomly allocated", no details
Allocation concealment (selection bias)	Low risk	Not mentioned
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not mentioned
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	No loss to follow‐up
Selective reporting (reporting bias)	Low risk	All results reported
Other bias	Low risk	Groups well balanced