Xu 2014.

Methods	Randomized controlled trial comparing dexmedetomidine versus placebo.
Participants	80 participants aged 41‐75 yr, ASA II‐III and diagnosis of coronary heart disease undergoing elective hip surgery with an expected duration > 2 hr. Age (yr): mean (SD): dexmedetomidine group: 60 (5); placebo: 59 (6). Sex: 37 men, 43 women. Exclusion criteria: history of hypertension, hypotension, diabetes mellitus, arrhythmia, cerebrovascular disease, severe arrhythmia, heart failure or a combination; taking non‐steroidal anti‐inflammatory drugs and hormonal medications for underlying diseases; any known sensitivity to study medications or previous anaesthetic exposure within 1 year; abnormal preoperative liver and kidney function; abnormal levels of cTnI, GP‐BB and myocardial enzymes; and LVEF < 40%.
Interventions	Dexmedetomidine 1 μg/kg IV bolus over 10 min followed by a maintenance infusion of 0.2 μg/kg/hr. Normal saline placebo administered in identical protocol.
Outcomes	MI (change in ST segment > 0.1 mV, development of a new Q wave) (24 hr).
Notes	Funding: grants from National Natural Science Foundation of China, Science and Technology Agency, Bureau of Chinese Medicine, Project of Medical Technology, Clinical Scientific Research of Medical Association and clinical scientific research fund of Chinese Medical Association. Declaration of interest: declared no conflict of interest.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "This study was a prospective randomized double‐blind trial." Random sequence generation not discussed.
Allocation concealment (selection bias)	Low risk	Sealed envelopes used. Opened by anaesthesiologist not involved in care of participant.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Drug prepared by separate anaesthesiologist uninvolved in participant care or study. Equal volume of normal saline used in control, and likely it was matched.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Blinded outcome adjudicator.
Incomplete outcome data (attrition bias) All outcomes	Low risk	All data reported.
Selective reporting (reporting bias)	Low risk	Outcomes reported were concordant with methods.
Other bias	Low risk	None.