Ali 2010.

Methods	Study design: randomized controlled trial (2 arms) Study duration: Febuary 2007 to September 2008 Study setting: hospital, single centre, Egypt
Participants	Adults undergoing elective trans‐nasal resection of pituitary tumours Inclusion criteria ASA I to ASA II Exclusion criteria Decreased level of consciousness Bleeding disorder Raised ICP Liver, renal, cardiac or pulmonary dysfunction Receiving drugs that affect coagulation or cardiovascular medications Mean age, range (years) 40 (20 to 60) Numbers allocated to each arm Group intervention (n = 15) Group control (n = 15) Male gender Group intervention: 9/15 Group control: 10/15
Interventions	Technique and timing Bilateral sphenopalatine ganglia blocks with 1.5 mL of 0.5% bupivacaine versus 1.5 mL of saline, administered after induction of anaesthesia (n = 30) Dosage 1.5 mL
Outcomes	Primary Intraoperative sevoflurane requirement Secondary Intraoperative nitroglycerine requirement Pain as measured by the visual analogue scale (VAS) measured at 30‐minute intervals up to 180 minutes after surgery Postoperative recovery time as measured by an Alderet Score of less than or equal to 9 Adverse events ‐ nausea and vomiting, sedation, headache, nose bleed, visual disturbance, agitation
Notes	Funding None
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Reported as randomized but method not reported
Allocation concealment (selection bias)	Low risk	Sealed envelopes
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Study solutions were prepared by an investigator who was not otherwise involved in the study.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Study solutions were prepared by an investigator who was not otherwise involved in the study.
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants were included in the final analysis.
Selective reporting (reporting bias)	Low risk	Outcomes reported as specified
Other bias	Unclear risk	Small study