What type of line is recommended for administering norepinephrine to prevent extravasation?

When administering norepinephrine, a potent vasopressor, it is crucial to minimize the risk of extravasation, which can lead to tissue necrosis and other complications. A centrally placed venous line, such as a central venous catheter, is recommended for this purpose.

Administering norepinephrine through a central line allows for direct infusion into the central circulation, reducing the risk of adverse effects associated with peripheral administration. The central line is situated in larger veins, which can tolerate the high concentrations and pH levels of norepinephrine better than smaller peripheral veins. Moreover, if extravasation does occur with a central line, the effects are more contained, and the situation can be managed more effectively.

In contrast, using a peripheral IV line may increase the likelihood of extravasation at the site, especially if the infusion is not carefully monitored. Subcutaneous lines are inappropriate for such a potent medication due to their inability to handle high pressures and risk of complications. Arterial lines, while useful for monitoring blood pressure and drawing blood, are not intended for drug administration, particularly of vasopressors like norepinephrine. Thus, the most appropriate method for delivering norepinephrine safely is through a centrally placed venous line.