Superficial Parasternal Block Combined With Rectus Sheath Block for Open Cardiac Surgery

The investigators will examine whether the combination of a superficial parasternal block and rectus sheath block with multimodal analgesia can enhance postoperative pain control and reduce opioid administration when compared to multimodal analgesia alone, in participants undergoing cardiac surgery and receiving standardized multimodal analgesia.

Inclusion Criteria: * Body weight ≥ 50 kg. * Primary cardiac surgery via a median sternotomy approach * Planned for fast-track procedure (i.e. postoperative extubation time of maximum six hours) Exclusion Criteria: * • Participation in another study within the 30 days preceding and during the present study * Emergency cardiac surgery * Previous cardiac surgery * Hypersensitivity or allergy to ropivacaine and other amide-class LA * History of chronic pain * History of substance abuse * Renal dysfunction (i.e. creatinine clearance ≤ 30 ml/min) * Severe cardiac dysfunction (i.e. LVEF ≤ 35%) * Severe obesity (BMI \> 40 kg/m2)