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Phenylephrine and norepinephrine are potent vasopressors used to manage intraoperative hypotension. Phenylephrine is a selective alpha-1 adrenergic receptor agonist that causes systemic vasoconstriction, increasing systemic vascular resistance and blood pressure, often with a reflex bradycardia. Norepinephrine is a catecholamine that acts as a potent agonist at alpha-1 and alpha-2 adrenergic receptors, and a less potent agonist at beta-1 receptors, providing both vasoconstriction and modest inotropic support. This specific research context involves a prospective, randomized, double-blind, cross-over clinical trial conducted by the London Health Sciences Centre Research Institute (Lawson Research Institute) to compare the effects of these two agents on cardiac function and myocardial ischemia in patients undergoing carotid endarterectomy under general anesthesia.
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