Efficacy of TTMPB in Adult Cardiac Surgery

The goal of this clinical trial is to compare the efficacy of Transversus Thoracic Muscle Plane Block (TTMPB) integrated in a modern multimodal analgesia protocol, following the ERAS® recommendations, in adult patients undergoing planned open heart surgery. The main study question is: Does the addition of TTMPB to a standard analgesic protocol significantly improve analgesia following elective open heart surgery? The investigators will primarily compare postoperative opioid consumption and pain scores in patients who will be randomly allocated to one of two groups: The control group will receive standard analgesia per institutional Intensive Care Unit protocol. The intervention group will receive the same standard of care plus a TTMP block (40ml of bupivacaine 0.375%, total dose of 150 mg). The investigators will also study the impact of group allocation on secondary outcomes, such as the rate of early mobilization.