Olesen ND, Frederiksen HJ, Storkholm JH, et al. - As mean arterial pressure (MAP) reduces after anesthesia, and vasopressors are often used to maintain MAP above 60 mmHg to preserve organ perfusion, researchers here examined if internal carotid artery (ICA) blood flow increases when MAP is kept higher than 60 mmHg using noradrenaline. They conducted a randomized, cross-over trial including patients who underwent pancreaticoduodenectomy (n = 19), total pancreatic resection (n = 1) or gastro-entero anastomosis (n = 2) during combined propofol-remifentanil and thoracic epidural anesthesia; median [IQR] age of the patients was 71 [63 to 75] years. In a random order, MAP was maintained between 60 to 65, 70 to 75 and 80 to 85 mmHg by noradrenaline infusion at a stable level of anesthesia. During combined propofol-remifentanil and thoracic epidural anaesthesia, increase in ICA flow was observed by nearly 15% when the MAP was raised from about 60 to 80 mmHg. Treatment of a reduction in MAP brought about by anesthesia appears to improve ICA flow.