One of the main concerns of intraoperative hypotension is adequacy of cerebral perfusion, as cerebral blood flow decreases passively when mean arterial pressure falls below the lower limit of cerebral autoregulation. Treatment of intraoperative hypotension includes administration of drugs, such as inotropes and vasopressors, which have different pharmacological effects on cerebral hemodynamics; there is no consensus on the preferred drug to use. We performed a network meta-analysis (NMA) to pool and analyze data comparing the effect on cerebral oxygen saturation (ScO₂) measured by cerebral oximetry of various inotropes/vasopressors used to treat intraoperative hypotension. We searched randomized control trials in Embase, Ovid Medline, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science. We included studies that enrolled adult patients undergoing surgery under general/spinal anesthesia that compared at least 2 inotropes/vasopressors to treat hypotension. We reviewed 51 full-text manuscripts and included 9 randomized controlled trials in our study. The primary outcome was change in ScO₂. Our results showed the likelihood that dopamine, ephedrine, and norepinephrine had the lowest probability of decreasing ScO₂. The suggested rank order to maintain ScO₂, from higher to lower, was dopamine <ephedrine <norepinephrine <phenylephrine. Drugs in the lower rank order, like phenylephrine, produce higher reductions in ScO₂. Compared with dopamine, the mean difference (95% credible interval) of ScO₂ reduction was: ephedrine −3.19 (−15.74, 8.82), norepinephrine −4.44 (−18.23, 9.63) and phenylephrine −6.93 (−18.31, 4.47). The results of our NMA suggest that dopamine and ephedrine are more likely to preserve ScO₂, followed by norepinephrine. Compared with the other inotropes/vasopressors, phenylephrine decreased ScO₂. Because of the inherent imprecision of direct/indirect comparisons, the rank orders are possibilities, not absolute ranks. Therefore the results of this NMA should be interpreted with caution.

术中低血压的主要问题之一是脑灌注是否充足，因为当平均动脉压低于脑自动调节下限时，脑血流量会被动减少。术中低血压的治疗包括给予药物，如正性肌力药和血管加压药，它们对脑血流动力学有不同的药理作用；对于首选药物的使用尚无共识。我们进行了一项网络荟萃分析 (NMA)，以汇集和分析比较对脑氧饱和度 (ScO _{2 ) 影响的数据}) 通过用于治疗术中低血压的各种正性肌力药/血管加压药的脑血氧测定法测量。我们在 Embase、Ovid Medline、Scopus、Cochrane Central Register of Controlled Trials 和 Web of Science 中检索了随机对照试验。我们纳入了在全身麻醉/脊髓麻醉下接受手术的成年患者纳入的研究，这些患者比较了至少 2 种正性肌力药/升压药治疗低血压的效果。我们审查了 51 份全文手稿，并在我们的研究中纳入了 9 项随机对照试验。主要结果是 ScO ₂的变化。_{我们的结果显示多巴胺、麻黄碱和去甲肾上腺素降低 ScO 2}的可能性最低。维持 ScO _{2的建议排列顺序}，从高到低依次为多巴胺<麻黄碱<去甲肾上腺素<去氧肾上腺素。较低等级的药物，如去氧肾上腺素，会产生较高的 ScO ₂降低。与多巴胺相比，ScO ₂减少的平均差异（95%可信区间）为：麻黄碱-3.19（-15.74，8.82），去甲肾上腺素-4.44（-18.23，9.63）和去氧肾上腺素-6.93（-18.31，4.47）。我们的 NMA 结果表明，多巴胺和麻黄碱更有可能保护 ScO ₂，​​其次是去甲肾上腺素。与其他强心药/血管加压药相比，去氧肾上腺素可降低 ScO ₂. 由于直接/间接比较固有的不精确性，排名顺序是可能的，而不是绝对排名。因此，应谨慎解释此 NMA 的结果。