Cardiac surgery is a source of severe post operative pain witch can cause major respiratory complications due to non optimal post operative rehabilitation.

Multimodal analgesia provides acceptable pain control , but does not seem sufficient during coughing or mobilization. The use of morphine also exposes patients to side effects (nausea, vomiting, pruritus, respiratory depression, chronic pain, ileus). Bleeding and hemodynamic risks of peridural and spinal aneshesia limits their use.

The postoperative efficacy of deep parasternal intercostal plane block has not yet been evaluated sufficiently. The aim of this study is to evaluate the efficacity of TTMPB on the quality of postoperative recovery after cardiac surgery.

Inclusion Criteria:

• Patients requiring cardiac surgery with sternotomy

Exclusion Criteria:

• Emergency procedure
• Procedures requiring lateral chest drainage
• Hemodynamic instability
• Severe kidney or liver failure
• BMI > 40
• Chronic pain
• Allergy to local anesthesics
• Pregnant woman
• Long term opioïds use