Lattermann 2007.
Methods | RCT Approved by the ethics committee and written informed consent obtained Setting: Canada Funding: unspecified |
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Participants | 20 patients undergoing elective open resection of localized, non‐metastatic colorectal carcinoma Exclusion criteria were evidence of metastatic disease, congestive heart failure, hepatic disease or diabetes; serum albumin < 35 g/L or anaemia (haemoglobin 100 g/L); and drugs known to have metabolic effects, such as corticosteroids or beta‐blockers |
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Interventions |
Treatment group: thoracic epidural analgesia (T9‐T11) with bupivacaine 0.5% for a sensory level from T4 to L3 before the surgical incision, bupivacaine 0.25% during surgery and bupivacaine 0.1% plus fentanyl 2 mcg/mL after surgery for at least 48 hours (n = 10) Control group: IV PCA with morphine (n = 10) General anaesthesia for all participants |
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Outcomes | VAS scores at rest and on movement at 24 and 48 hours | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | "randomized", no details |
Allocation concealment (selection bias) | Unclear risk | Not mentioned |
Blinding of participants and personnel (performance bias) All outcomes | High risk | "Both anaesthesiologist (TS, RL) and surgeon (SM) were aware of the individual patient’s group assignment" |
Blinding of outcome assessment (detection bias) All outcomes | High risk | "Both anaesthesiologist (TS, RL) and surgeon (SM) were aware of the individual patient’s group assignment" |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No loss to follow‐up |
Selective reporting (reporting bias) | Low risk | No missing information |
Other bias | Low risk | Both groups were homogeneous with respect to type of surgery (epidural group: 8 sigmoid colectomy, 2 hemicolectomy; intravenous analgesia group: 7 sigmoid colectomy, 2 hemicolectomy) |