Rohan 2005.

Methods	RCT, parallel design, single‐centre
Participants	Total number of randomized participants: 30 Inclusion criteria: Elderly patients (> 65 years of age) presenting for minor urological (rigid cystoscopy, transurethral resection of bladder mucosal tumour) or gynaecological surgery (hysteroscopy), requiring GA, and with an anticipated hospital stay of one night postoperatively Exclusion criteria Diseases of the central nervous system including pre‐existing cognitive dysfunction (defined as a MMSE < 24) Consumption of phenothiazines or antidepressants Cardiac or neurosurgery Previous neuropsychological testing Poor comprehension of the language used in processing the tests Patients with alcoholism or addictive drug dependence Type of surgery: minor urological or gynaecological surgery Baseline characteristics TIVA group Age, mean (range): 72.9 (65 to 83) years Gender, M/F: 12/3 ASA grade: not reported Inhalational maintenance group Age, mean (range): 73.8 (67 to 86) years Gender M/F: 11/4 ASA grade: not reported Country: Ireland Setting: hospital
Interventions	TIVA group Participants: n = 15; 0 losses Induction details: 500 mL crystalloid solution, fentanyl 1 µg/kg IV, propofol TCI using a Deprifusor Maintenance details: TCI propofol adjusted to maintain adequate depth of anaesthesia, at discretion of attending anaesthetist. 50% O2 and 50% air Inhalational maintenance group Participants: n = 15; 0 losses Induction details: 500 mL crystalloid solution, fentanyl 1 µg/kg IV. Incremental dose of sevoflurane by tidal volume inhalation induction technique Maintenance details: 50% O2 and 50% air. No additional information for maintenance
Outcomes	Cognitive dysfunction on the day following surgery S‐100β and neuron‐specific enolase levels
Notes	Funding/declarations of interest: funded entirely from the resources of the Department of Anesthesia, Critical Care and Pain Medicine, Mater Misericordiae Hospital Study dates: not reported Note: study also includes an age‐matched control group of participants which we did not include in the review
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Participants were randomized to groups; no additional details
Allocation concealment (selection bias)	Low risk	Use of sequentially numbered sealed envelopes
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	Low risk	Quote: "the investigator who undertook patient enrolment, neuropsychological tests and blood tests did not deliver anaesthesia to the patient and, therefore, was unaware of study group allocation."
Incomplete outcome data (attrition bias) All outcomes	Low risk	No apparent loss of study participants
Selective reporting (reporting bias)	Unclear risk	Study authors do not report clinical trials registration. Not feasible to assess risk of selective outcome reporting
Other bias	Unclear risk	No detail on doses of anaesthetic drugs. Unable to assess whether groups were equivalent