Giger‐Mateeva 1999

Methods	Double‐blind, single‐centre, placebo‐controlled RCT. Cross‐over design: investigators crossed over all participants to the alternative intervention.
Participants	10 participants with cirrhosis and no clinical evidence of overt hepatic encephalopathy; 5 participants had minimal hepatic encephalopathy based on the finding of either abnormal visual evoked potentials or Number Connection Test results. Age (range): 40 to 60 years. Proportion of men: 80%. Aetiology of cirrhosis: alcohol 30%; hepatitis B/C 70%. Proportion testing positive for benzodiazepines at baseline (Table 7): 0%.
Interventions	Intervention comparison: intravenous infusion flumazenil 1 mg over 2 minutes versus placebo. Total dose of flumazenil: 1 mg. Washout period: 4 hours. Cointerventions: none reported.
Outcomes	Outcomes included in meta‐analyses: none.
Neuropsychiatric assessment	At baseline and post infusion: Visual evoked potential at baseline and every 8, 16, 24, 32, and 40 minutes after infusion; Visual reaction time at baseline and 5, 10, and 20 minutes after infusion; Auditory reaction time at baseline and 5, 10, and 20 minutes after infusion; Number Connection Test at baseline and 10 minutes after infusion.
Inclusion period (date)	Not described.
Country	The Netherlands.
Notes	Included data: trial did not include separate information about the first allocation period. Therefore, we were unable to include the trial in our meta‐analyses.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not described.
Allocation concealment (selection bias)	Low risk	Concealed drug containers.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Blinding of participants and personnel.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blinding of outcome assessment.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data.
Selective reporting (reporting bias)	Low risk	The trial describes clinically relevant outcomes. We had no access to information about outcomes described in the original protocol or information in trial registries.
For‐profit funding	Unclear risk	No information provided.
Other bias	Low risk	No other biases.
Overall assessment	High risk	High risk of bias.