Muralidhar 2008

Methods	RCT
Participants	Country: India N = 40 (enrolled) (20 isoflurane, 20 propofol) Operation: elective off‐pump coronary artery bypass grafting (CABG) Exclusion: Patients with poor ventricular function of lesser than 40%; left ventricular aneurysms; and renal/hepatic dysfunction, requiring extra corporeal circulation; preoperative or intraoperative intraaortic balloon pump, presence of unstable angina, carotid stenosis, cerebrovascular accident; excessive alcohol intake and drug abuse Isoflurane Gender: male/female 9/1, 8/2 Age: 50±6, 50±4 years Weight: 71±5, 71±6 kg Propofol Gender: male/female 8/2, 10/0 Age: 52±7, 47±5 years Weight: 71±6, 71±4 kg
Interventions	BIS‐guided isoflurane administration, target BIS (Zipprep, Aspect Medical System, Natick, MA, USA) value = 50±5); Cn = 10 No BIS‐guided isoflurane anaesthesia, maintaining end tidal isoflurane 1‐2%, Cn=10 BIS‐guided propofol administration, target BIS (Zipprep, Aspect Medical System, Natick, MA, USA) value = 50±5); Cn = 10 No BIS‐guided propofol anaesthesia, propofol 6‐8 mg/kg/hr during sternotomy and 4‐6 mg/kg/hr during maintenance; Cn=10
Outcomes	‐Amount of isoflurane (ml) or propofol (ml) ‐Time to extubation ‐Intraoperative recall awareness
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information regarding the sequence generation process
Allocation concealment (selection bias)	Low risk	"Patients were randomly divided into four groups by a sealed envelope technique.."
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Insufficient information regarding withdrawal/dropouts
Selective reporting (reporting bias)	Low risk	All expected outcomes reported
Other bias	Unclear risk	The unblinded anaesthesiologists could potentially lead to ' learning contamination bias" during administration of the anaesthetics
Blinding of patients?	Low risk	All patients were anaesthetized
Blinding of anaesthesiologists?	High risk	It is unlikely to blind the anaesthesia providers who delivery the anaesthetics
Blinding of outcome assessors?	Unclear risk	insufficient information. The study has not stated clearly whether the intensive care unit research fellow, who was an interviewer, blinded to the group assignment or not