Document resource
Background The deleterious effect of intraoperative hypotension has been emphasised by many observational studies. However, vasopressor therapies to treat intraoperative hypotension, specifically the choice between phenylephrine and norepinephrine, have been debated. There is a crucial need for additional studies to determine the most appropriate choice for vasopressor therapy in the context of this variable use.Methods and analysis A sequential explanatory mixed-methods design is proposed to expand the knowledge base relating to vasopressor selection during non-cardiac surgery and inform the education surrounding and extrapolation of the results of a pragmatic clinical trial. The three phases will consist of an observational study using rigorously validated multicentre electronic health record data, a web-based survey targeting clinicians and a semistructured interview targeting a subsample of survey respondents. These research aims will address areas with insufficient data: (1) the quantification of practice patterns and variation of vasopressor selection within non-cardiac operating rooms and (2) the reasoning behind these clinical decisions. This study will serve as primary steps to develop and provide context for the future results of a multicentre pragmatic clinical trial comparing the impact of phenylephrine and norepinephrine on postoperative patient outcomes.Ethics and dissemination This study has received Institutional Review Board (IRB) exemption from the University of Michigan. We plan to disseminate results through peer-reviewed journal articles, conference proceedings and presentations.