Sharma 2018.

Methods	RCT, parallel design
Participants	Total number of randomized participants: 60 Inclusion criteria: either gender; 20‐50 years of age; ASA status I or II; scheduled for elective surgery under GA Exclusion criteria: anticipated difficult airway; laryngoscopy time > 20 seconds; history of hypertension, diabetes, hepatic disease or renal disease; on preoperative beta‐blockers; pregnant or lactating women Type of surgery: elective general surgery (types not specified ‐ we assumed non‐cardiac) Baseline characteristics Intervention group (esmolol) Age, mean (SD): 30.86 (± 8.65) years Gender, M/F: 18/12 ASA status I/II: 11/19 Control group (placebo) Age, mean (SD): 31.46 (± 9.0) years Gender, M/F: 21/9 ASA status: 10/20 Country: India Setting: single centre; hospital
Interventions	Intervention group (esmolol) Randomized, n = 30; losses = 0; analysed, n = 30 (use of ITT analysis not reported) Details: infusion of esmolol 1.5 mg/kg diluted in 20 mL normal saline before induction of anaesthesia Control group (placebo) Randomized, n = 30; losses = 0; analysed, n = 30 Details: 20 mL normal saline, given same as the intervention group
Outcomes	Outcomes measured/reported by study authors: haemodynamic variables; myocardial insult (not defined); hypotension (not defined); bradycardia (not defined) Outcomes relevant to the review: hypotension; bradycardia
Notes	Funding/declarations of interest: no funding sources and study authors report no conflicts Study dates: not reported Note: study includes an additional group (dexmedetomidine), which we did not include in the review
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated randomization, completed by anaesthetist who was not involved in drug administration or outcome assessment
Allocation concealment (selection bias)	Low risk	See above
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Placebo‐controlled trial, anaesthetists not aware of group allocation
Blinding of outcome assessors (detection bias) All outcomes	Low risk	Recordings made by a separate anaesthetist blinded to group allocation
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