A review.A Review.VASOPRESSORS ARE INVALUABLE TOOLS for treating hemodynamic instability in emergency departments, operating rooms, and intensive care units.Some examples of vasoactives include phenylephrine, ephedrine, norepinephrine, vasopressin, dopamine, and angiotensin II.Vasoconstrictors are extremely beneficial in treating distributive shock as they share the common mechanism of providing vasoconstriction.However, despite its rarity, the extravasation of these agents from the vascular bed into peripheral tissue remains a high concern.In addition to not achieving the medication′s desired effect, complications include tissue hypoperfusion, pain, soft tissue and nerve damage, ischemia, and necrosis Although peripheral venous access may be more readily and easily available to obtain, central venous access has traditionally been the preferred route of vasopressor administration to avoid extravasation and its complications.While evidence to support peripheral vasopressor administration is growing, there are serious limitations to such data, and existing reviews have acknowledged a high propensity for bias.Current evidence supporting continuous and prolonged infusion of vasopressors through peripheral i.v. catheters is weak.There are observational studies to support peripheral infusion in case of emergency for temporary periods in a protocolized manner, but many guidelines regarding peripheral vasoactive administration are not standardized or generally applicable across multiple institutions and hospital settings.Large, multicenter, prospective randomized controlled trials must be performed to document safety and noninferior data in peripheral compared with central access.For now, central lines should remain the preferred route of access as central access can provide addnl. benefits beyond safety.