Davis 1987.

Methods	RCT Approved by the five Ethics Committee of the participating hospitals
Participants	Orthopaedic hospitals in New Zealand ‐ multicentre study 549 (538 analysed) participants with a proximal femoral fracture Mean age 79.5 years (range not stated) Male: 22% Number lost to follow‐up: 0, but 11 excluded 20% subcapital and 80% trochanteric fractures Excluded if < 55 years of age, arthroplasty required, pathological fracture or contraindication to one anaesthetic technique
Interventions	Treatment group: Spinal anaesthesia with sedation with diazepam. Hyper of isobaric tetracaine, nupercaine or bupivacaine for spinal (n= 259 analysed) Control group: General anaesthesia with pre‐oxygenation, IV induction with thiopentone, IPPV maintained with nitrous oxide/oxygen, non‐depolarizing neuromuscular blocker, fentanyl (n = 279 analysed)
Outcomes	Mortality at 1 month (28 days) Operative hypotension requiring vasopressor Length of hospital stay
Notes	There was 1 non fatal anaphylactoid reaction at induction of general anaesthesia Length of follow‐up: 1 month A longer duration of follow‐up was available for a fraction of the patients only and therefore was not reported to decrease the chances of selective reporting
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomized with stratification by sex and hospital
Allocation concealment (selection bias)	Unclear risk	Not mentioned
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not mentioned
Blinding of outcome assessment (detection bias) All outcomes	High risk	Not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	11 excluded out of 549. Exclusion were made on pre‐defined criteria: age less than 55 years, multiple trauma, possible replacement or hemi‐arthroplasty or pathological fractures
Selective reporting (reporting bias)	Low risk	30 failed spinal and 14 incomplete
Other bias	Low risk	Groups well balanced. Intention‐to‐treat