Zaric 2006.

Methods	Randomized trial: computerized random number tables
Participants	Single centre in Copenhagen, Denmark 60 participants undergoing TKR with general anaesthesia Inclusion criteria: ASA I to III Exclusion criteria: morphine intolerance, neurological disease, coagulation disturbance and chronic pain and rheumatoid arthritis Mean age (years): 66 ± 7 Female: 53% Number excluded post randomization: 11 participants (four in continuous FNB and seven in epidural group) Number lost to follow‐up: none
Interventions	1. Continuous FNB + sciatic with bolus 30 ml of ropivacaine 7.5 mg/ml and Infusion ropivacaine 2 mg/ml and sufentanil 1 μg/ml at 5 ml/h through femoral nerve catheter; and bolus 30 ml of ropivacaine 7.5 mg/ml and Infusion ropivacaine 0.5 mg/ml at 5 ml/h through sciatic nerve catheter 2. Epidural with ropivacaine 7.5 mg/ml given in 5‐ml aliquots to attain a level of analgesia at Th 10, and infusion ropivacaine 2 mg/ml and sufentanil 1 μg/ml at 5 ml/h All infusions were continued for 55 hours Adjunct analgesics: IV PCA morphine bolus 2 mg with lockout period of six minutes and maximum dose of 20 mg/h, paracetamol 1 g four times daily. If VAS > three at rest, 5 ml ropivacaine 7.5‐mg/ml bolus given through catheters. If pain score > five, 5 ml lidocaine 20‐mg/ml bolus given. After cessation of infusions, rofecoxib 25 mg, sustained‐release morphine (Contalgin) 20 mg (10 mg for participants > 70 years) twice daily and morphine 10 mg
Outcomes	Outcomes of interest for the review: Pain intensity at rest and on movement: visual analogue scale, four hours post operation, 11 am and 14.30 pm on first, second and morning of third postoperative days Total opioid consumption: postoperative days one and two Nausea/vomiting Dizziness (moderate to severe) Sedation Pruritus Urinary retention Adverse events Knee flexion: postoperative day one, discharge Other outcomes: Rehab indices Length of stay
Notes	Study author provided additional data on mean (SD) for pain intensity on movement and at rest with knee ROM flexion
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computerized random number tables
Allocation concealment (selection bias)	Low risk	Sealed opaque envelopes
Blinding of participants and personnel (performance bias) Subjective outcomes	High risk	Blinding of groups not attempted
Blinding of outcome assessment (detection bias) Subjective outcomes	High risk	Blinding of groups not attempted
Incomplete outcome data (attrition bias) All outcomes	High risk	11 participants (18%) excluded post randomization (four in continuous FNB and six in epidural group because of insufficient analgesia;.one in epidural group had an acute myocardial infarction followed by coronary artery bypass graft)
Selective reporting (reporting bias)	Low risk	Outcomes predefined
Other bias	Unclear risk	Potential impact of high attrition on ITT bias may be an issue, as the study did not use ITT analysis

Abbreviations:

ASA: American Society of Anaesthesiologists; BD: twice a day; BMI: body mass index; COX: cyclo‐oxygenase; CPM: continuous passive motion; CPNB: continuous peripheral nerve block; FNB: femoral nerve block; IQR: interquartile range; ITT: intention‐to‐treat; NSAID: non‐steroidal anti‐inflammatory drug; PACU: postanaesthesia care unit; PCA: patient‐controlled analgesia; PCEA: patient‐controlled epidural analgesia; ROM: range of motion; SD: standard deviation; SF: Short Form; TKR: total knee replacement; VAS: visual analogue scale; WOMAC: Western Ontario and McMaster Osteoarthritis Index.