Gherghina 2010.

Methods	RCT Approved by the ethics committee and written informed consent obtained Setting: Romania Funding: unspecified
Participants	70 patients older than 70 years of age and undergoing major abdominal surgery (gastrointestinal mainly). Criteria for inclusion of patients in the study were age over 70 years, ASA physical status 1 to 3, major abdominal surgery, normal preoperative neurological status and Abbreviated Mental Test score ≥ 8
Interventions	Treatment group: TEA/LEA with bupivacaine 0.125% and sufentanil 5 mcg/mL started before surgery and kept for 79 hours (n = 35 randomized; 33 analysed) Control group: IV PCA with morphine (n = 35 randomized; 31 analysed) General anaesthesia with propofol, sufentanil, sevoflurane and atracurium. Rescue analgesia (VAS > 3) with paracetamol (1 G IV) or ketoprofen 100 mg IV
Outcomes	Time to return of intestinal transit (taken as time to first flatus)
Notes	Study authors contacted on 23 June 2015, but did not reply
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"randomisation table"
Allocation concealment (selection bias)	Unclear risk	Not mentioned
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not mentioned
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	High risk	Six participants lost to follow‐up: 4 in the epidural group and 2 in the opioid‐based regimen group
Selective reporting (reporting bias)	Low risk	All results reported
Other bias	Unclear risk	Groups well balanced Not in intention‐to‐treat