Marandola 2008.

Methods	RCT Setting: Italy Funding: unspecified
Participants	40 patients enrolled to undergo surgical procedure for pancreatic or periampullary cancer
Interventions	Treatment group: TEA (T9–T10 and catheter inserted approximately 4 to 5 cm into the epidural space in a presumed cranial direction) with ropivacaine 0.2% and morphine 0.05 mg/mL (n = 16). Duration unspecified but taken as 42 hours because participants received 420 mg of 0.2% at 5 mL/h Control group: IV morphine infusion (n = 24) General anaesthesia for all participants; rescue analgesia provided by IV infusion of tramadol every 6 hours if required
Outcomes	VAS scores at rest at 24 hours VAS scores on movement at 24 hours Vomiting
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"Randomly divided", no details and groups unequal (16 vs 24)
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	Low risk	No loss to follow‐up
Selective reporting (reporting bias)	Low risk	All results reported
Other bias	Unclear risk	Groups highly unequal in number (16 vs 24)