What is the main reason norepinephrine should be infused through a central line rather than a peripheral vein?

• A. To minimize phlebitis
• B. To ensure rapid infusion
• C. To prevent tissue necrosis from extravasation
• D. To simplify monitoring

Answer: (C)

Giving norepinephrine through a central line is preferred because this powerful vasoconstrictor can cause severe tissue damage if it leaks into surrounding tissue. A peripheral IV is more prone to extravasation, and when norepinephrine escapes into tissue, it can cause intense vasoconstriction locally, leading to ischemia and tissue necrosis. Placing the drug in a central vein provides better dilution in the bloodstream and reduces the amount that reaches peripheral tissues if a leak were to occur. While a central line may also support controlled, continuous infusion, the critical safety benefit here is preventing tissue injury from extravasation.