This Study aimed to assess The Effectivity of Bilateral Transversus Thoracis Muscle Plane Block to Reduce Pain and Stress Response After Open Heart Surgery

This is a double blind randomized controlled trial. Thirty-two subject will be recruited with non-probability consecutive sampling method. Subjects who meet all inclusion criteria and do not have exclusion criteria will be asked to sign the informed consent form before included in this study. Subjects will be randomized into two groups. The first group is the treatment group who will get Bilateral Transversus Thoracis Muscle Plane Block after induction of anesthesia and the second group will be the control group who will not get any regional block during surgery. After surgery, time to first morphine dose, total morphine consumption in 24 hours, extubation time, and adverse events will be recorded for both group.

Inclusion criteria:

1. Age 19-75 years old
2. Patients who will undergo elective open heart surgery with median sternotomy approach

Exclusion criteria:

1. Patient who does not agree to be included in this study
2. weight <45kg or >75 kg
3. Patient with chronic obstructive pulmonary disease
4. Patient with chronic kidney disease who needs regular hemodialysis.
5. Patient with local infection in the injection area for transversus thoracis muscle plane block
6. Patient with chronic pain
7. Patient with history of chronic analgetics drugs usage
8. Patient who is contraindicated for local anesthetics
9. Patient with communication disability
10. Patient with cognitive disorders
11. Patient with severe psychiatrics disorders, such as schizophrenia and bipolar disorder