The Effect of Superficial Parasternal Intercostal Plane Block on Pulmonary Function Tests After Cardiac Surgery

In adult patients undergoing cardiac surgery, does adding an sPIP block to standard care compared to standard care alone result in a smaller decrease in PFTs?

Inclusion criteria: * Patients who are scheduled to undergo elective cardiac surgery via sternotomy (i.e., coronary artery bypass graft, valvular surgery, and combined surgery). * Body Mass Index (BMI) above 20 and below 40 kg m-2 * Age above 18 years. * Eligible to sign informed consent. Exclusion criteria: * Emergency surgery. * Redo surgery. * Off-pump surgeries. * Pregnancy. * Preoperative mechanical circulatory support (i.e., intra-aortic balloon pump, extracorporeal membrane oxygenation, ventricular assist devices). * Preoperative chronic pain (i.e., fibromyalgia, chronic neuropathic pain). * Contraindication for regional analgesia (i.e., known allergy to LA, skin lesions in the injection site). * Known allergy to one or more of the components of multimodal analgesia (i.e., opioids, paracetamol, tramadol, dipyrone). * Preexisting severe pulmonary disease (i.e., an obstructive lung disease with FEV1 below 49%, restrictive lung disease with FVC below 49%, pulmonary hypertension). Criteria For Discontinuing (Postoperative Exclusion Criteria): * Prolonged cardiopulmonary bypass (CPB) of more than three hours. * Transfusion of more than three units of blood products. * Severe coagulation disturbance requiring prothrombin complex concentrate or recombinant factor VII. * Left ventricular failure with vasoactive-inotropic score (VIS) at the end of the surgery of ≥ 20. * Right ventricular failure requires inhaled nitric oxide. * Need for mechanical circulatory support (i.e., intra-aortic balloon pump, extracorporeal membrane oxygenation). * Patients requiring mechanical ventilation for more than 24 hours postoperatively.