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Although hypotension due to decrease in systemic vascular resistance resulting from the blockade of preganglionic sympathetic fibres remains a problem with all central neuraxial blocks; the synergistic action of local anaesthetics with opioid can be of great benefit in achieving adequate anaesthesia with lesser dose of local anaesthetics, thereby reducing chances and severity of hypotension.
Preganglionic sympathetic fibers originate in the first and second thoracic segments and synapse in the cervical sympathetic ganglia.
Low concentrations will block only preganglionic sympathetic fibers, in this study we found that sufentanil and fentanyl acts synergistically with 0.