Jellish 2003.

Methods	RCT, parallel design, single‐centre
Participants	Total number of randomized participants: 60 (unclearly reported in paper, possibly 59 randomized participants) Inclusion criteria Undergoing unilateral carotid endarterectomy Exclusion criteria Undergoing emergency surgery In atrial fibrillation Significant renal or hepatic disease Type or surgery: carotid endarterectomy Baseline characteristics TIVA group Age, mean (SD): 72.1 (± 1.5) years Gender: 55% male ASA grade: all patients were ASA III Inhalational maintenance group Age, mean (SD): 69.2 (± 1.7) years Gender: 62% male ASA grade: all patients were ASA III Country: USA Setting: single‐centre
Interventions	TIVA group Participants: n = 30; 0 losses Induction details : propofol 1.0 mg/kg to 1.5 mg/kg IV. Remifentanil infusion started at 0.25 µg/kg/min. Additional propofol 25 mg to 50 mg IV given if necessary to maintain MAP within 10 % pre‐induction values during intubation Maintenance details: propofol 50 µg/kg/min to 75 µg/kg/min. Remifentanil 0.125 µg/kg/min to 0.5 µg/kg/min. Adjusted to maintain haemodynamic parameters within 15% pre‐induction. N2O in O2 mix 60/40 Other information: hypertension non‐responsive to anaesthesia treated with sodium nitroprusside 0.5 µg/kg/min. Hypotension non‐responsive to anaesthesia treated with phenylephrine 40 µg to 80 µg IV. Tachycardia unresponsive to anaesthesia treated with esmolol 10 mg to mg 20 mg IV, bradycardia treated with glycopyrrolate 0.2 mg IV Inhalational maintenance group Participants: number of randomized participants is unclearly reported. We have assumed that 30 participants were randomized, with 1 loss (owing to technical difficulties with transoesophageal probe), and 29 participants were analysed. Induction details: propofol 1.5 mg/kg to 2 mg/kg IV, fentanyl 2 µg/kg. Additional propofol 25 mg to 50 mg IV given if necessary to maintain MAP within 10 % pre‐induction values during intubation Maintenance details: isoflurane 0.5% to 2% end‐tidal. Titrated to maintain MAP 15% pre‐induction values. N2O in O2 mix 60/40 Other information: other drugs to maintain stability same as TIVA group
Outcomes	Haemodynamic variables (hypertension, hypotension, tachycardia, bradycardia) Emergence and recovery data to include length of time in PACU, time to hospital discharge, cardiac performance (using TEE)
Notes	Funding/declarations of interest: not reported Study dates: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Use of computer generated randomization
Allocation concealment (selection bias)	Unclear risk	No details
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not feasible to blind anaesthetists to intervention groups
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No details
Incomplete outcome data (attrition bias) All outcomes	Low risk	One participant lost from inhalation group, which is unclearly reported. We have assumed that 30 participants were randomized to the inhalation group, with one loss. We were not concerned by risk of attrition bias because losses were few and unlikely to influence outcome data
Selective reporting (reporting bias)	Unclear risk	Study authors do not report clinical trials registration. Not feasible to judge risk of selective outcome reporting
Other bias	Unclear risk	Study includes comparison of remifentanil with fentanyl, which introduces methodological differences between groups. Also note differences in amount of propofol given at induction