This study examine the effect of Parasternal Intercostal Nerve Blocks with local anesthetic on pain control in patients undergoing non-emergent cardiac surgery in a prospective controlled trial. Half of participants will receive General Anesthesia combined to parasternal block while the other half receive only General Anesthesia.

60 patients undergoing elective cardiac surgery will be enrolled and divided into two groups:

1. Interventional (parasternal group)
2. Case control group The "parasternal group" of patients will receive the pre-operative parasternal block (20 ml of 0.5% Ropivacaine per side) in association with infiltration with local anesthetic of access to thoracic drainage (drainage infiltration with 20 ml of 0.25% Ropivacaine) at the end of the intervention combined to General Anesthesia.

The "case control group" will only receive drainage infiltration with local anesthetic and standard intraoperative management with opioids.

Inclusion Criteria:

• Patients undergoing elective cardiac surgery
• Age over 18 years
• ASA I-IV
• Approval by the patient of informed consent

Exclusion Criteria:

• Allergy to local anesthetics
• Puncture site infection
• Lack of signing of informed consent
• Weight <30 Kg
• Age <18 years
• Emergency interventions
• ASA > IV
• Sternal dehiscences
• Dementia (for difficulties in managing weaning from mechanical ventilation and pain)