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. 2019 Dec 1;2019(12):CD003006. doi: 10.1002/14651858.CD003006.pub4

Etezadi 2013.

Methods Randomization: yes
Participant blinding: unclear
Provider blinding: no
Assessor blinding: yes
Dropouts: 0
Participants Country: Iran
ASA: I and II
Gender: men and women
Age range: 18–60 years
Ambulatory surgery: no
Surgical positioning: supine, lithotomy
Number of participants: 250
Interventions Drug 1: 5% lido, hyperbaric, variable dose (1.5–2 mL)
Drug 2: 0.5% bupi, isobaric, variable dose (2.5–3 mL)
Needle: 25 g sharp and pencil point
Outcomes TNS
Notes Follow‐up duration: 5 days
Follow‐up method: in person, unclear after 48 hours ("visited")
TNS therapy: NSAIDs
TNS resolution: unclear
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "… randomization was achieved by a computer‐generated block of numbers and sealed envelope technique."
Allocation concealment (selection bias) Unclear risk Quote: "… randomization was achieved by a computer‐generated block of numbers and sealed envelope technique."
Comment: did not specify allocation by sequentially numbered, sealed, opaque envelopes.
Participant blinding (performance bias and detection bias) Low risk Study was described as "double‐blind" but otherwise participant blinding was not addressed.
Provider blinding (performance bias) High risk Volumes of local anaesthetic were not the same for the 2 interventions, thus provider not blinded.
Assessor blinding (detection bias) Low risk Quote: "the symptoms of TNS… were observed by a neurosurgeon that was blinded to… the type of drug… used for spinal anesthesia."
Incomplete outcome data (attrition bias) 
 All outcomes Low risk 250 participants enrolled, data reported for 250 participants.
Selective reporting (reporting bias) Unclear risk Study protocol not available.