Paulsen 2001.

Methods	RCT Approved by the Institutional Review Board and informed consent obtained Setting: United States of America Funding: unspecified
Participants	49 patients (men and women) aged 18 years or older who were scheduled to undergo elective small bowel or colon resection with a primary anastomosis
Interventions	Treatment group: TEA (T10‐T12) with bupivacaine 0.1% and fentanyl 5 mcg/mL for 3.7 days as a mean (n = 23) Control group: IV PCA with morphine or meperidine (n = 21) General anaesthesia for all participants
Outcomes	Time to first flatus Time to first faeces VAS scores (taken as at rest) at 24, 48 and 72 hours Leak Hospital length of stay Cost (analgesia plus room)
Notes	4% of participants (n = 1) in the EPI arm required removal of bupivacaine from the epidural solution secondary to lower extremity paraesthesia
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	"the study was not blinded"
Blinding of outcome assessment (detection bias) All outcomes	High risk	"the study was not blinded"
Incomplete outcome data (attrition bias) All outcomes	Low risk	49 participants were enrolled into the study. 5 of these participants were removed after enrolment (1 (EPI) and required mechanical ventilation for 24 hours after surgery, 3 (PCA) were not able to provide pain scores and 1 (PCA) was found to have extensive bowel necrosis at laparotomy and did not undergo resection
Selective reporting (reporting bias)	Low risk	All results reported
Other bias	Unclear risk	More diabetic participants in the opioids group. The type of surgical procedure performed was similar between the 2 groups Not in intention‐to‐treat