Harasawa 2006.

Methods	RCT, parallel design
Participants	Total number of randomized participants: 32 Inclusion criteria: undergoing surgery for intracranial or maxillofacial tumours under GA; ASA I or II; intraoperative HR > 90 bpm for > 5 min and SBP > 100 mmHg Exclusion criteria: > 75 years of age; heart disease including arrhythmias; bronchial asthma; receiving preoperative cardiovascular medications Type of surgery: surgery for intracranial or maxillofacial tumours Baseline characteristics Intervention group (landiolol 0.1 mg/kg) Age, mean (SD): 51 (± 16) years Gender, M/F: 4/4 Intervention group (landiolol 0.2 mg/kg) Age, mean (SD): 44 (± 14) years Gender, M/F: 4/4 Intervention group (landiolol 0.3 mg/kg) Age, mean (SD): 45 (± 17) years Gender, M/F: 4/4 Control group (placebo) Age, mean (SD): 48 (± 14) years Gender, M/F: 4/4 Country: Japan Setting: single centre; university hospital
Interventions	Intervention group (landiolol 0.1 mg/kg) Randomized, n = 8; losses = 0; analysed, n = 8 (use of ITT analysis not reported) Details: started 2 h after start of surgery, if HR > 90 bpm for > 5 min and SBP > 100 mmHg, 0.1 mg/kg landiolol, IV, over 10 seconds Intervention group (landiolol 0.2 mg/kg) Randomized, n = 8; losses = 0; analysed, n = 8 (use of ITT analysis not reported) Details: using 0.2 mg/kg landiolol, same as other intervention groups Intervention group (landiolol 0.3 mg/kg) Randomized, n = 8; losses = 0; analysed, n = 8 (use of ITT analysis not reported) Details: using 0.3 mg/kg landiolol, same as other intervention groups Control group (placebo) Randomized, n = 8; losses = 0; analysed, n = 8 (use of ITT analysis not reported) Details: 0 mg/kg (described as a placebo in abstract), same as the intervention groups
Outcomes	Outcomes measured/reported by study authors: haemodynamic variables; hypotension (SBP < 80 mmHg); bradycardia (HR < 50 bpm); ischaemic changes on ECG Outcomes relevant to the review: hypotension; bradycardia
Notes	Funding/declarations of interest: not reported Study dates: not reported Note: we combined data in analysis for all landiolol groups
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not specified
Allocation concealment (selection bias)	Unclear risk	Not specified
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Described as placebo‐controlled, but blinding is not reported
Blinding of outcome assessors (detection bias) All outcomes	Unclear risk	Not specified
Incomplete outcome data (attrition bias) All outcomes	Low risk	No apparent losses
Selective reporting (reporting bias)	Unclear risk	Study authors did not report prospective clinical trial registration or publication of a protocol. It was not feasible to effectively assess risk of reporting bias
Other bias	Low risk	Not detected