Juelsgaard 1998.

Methods	RCT Approved by the Ethics Committee
Participants	Orthopaedic hospital in Aarhus, Denmark 29 followed‐up out of 54 patients with proximal femoral fracture and known coronary artery disease. Patients with a recent (< 6 months) myocardial infarction excluded For 29 patients included in this review: Age: mean 80.9 years (range 65‐99) Male: 13% Number lost to follow‐up: 0, but 11 excluded from original trial population
Interventions	Treatment groups: Single shot (n = 15) with 2.5 mL of 0.5% bupivacaine or incremental doses (0.5 mL every 15 minutes) (n = 14) of the same drug. Considered as two subgroups of the same study Control group: General anaesthesia with fentanyl 1‐2 mcg/kg, 1‐4 mg/kg thiopentone, 0.5 mg/kg atracurium, nitrous oxide and oxygen and enflurane (n = 14). This group was split in half to be compared with each treatment group separately All patients were premedicated with pethidine 1 mg/kg and received supplemental oxygen for 12 hours after the surgery
Outcomes	Mortality at 1 month Operative hypotension (number of patients with 33% reduction in systolic arterial blood pressure from baseline) Myocardial infarction (World Health Organization criteria)
Notes	Presenc/absence of thromboprophylaxis not mentioned Length of follow‐up: 1 month
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	Not mentioned
Blinding of outcome assessment (detection bias) All outcomes	Low risk	"The investigator was blinded to the treatment group" (ischemias)
Incomplete outcome data (attrition bias) All outcomes	Low risk	No loss to follow‐up
Selective reporting (reporting bias)	Low risk	No failed spinal mentioned
Other bias	Low risk	Groups well balanced