Effect of ropivacaine infiltration through pre-sternal multi-orifice catheter for post-sternotomy pain relief in adult patients undergoing cardiac surgery

Cardiac surgery induces severe postoperative pain, resulting in impairment of pulmonary function, increased duration of hospital stay with increased morbidity and mortality1. Inadequate pain control reduces the capacity to cough, mobility, increases the frequency of atelectasis and prolongs recovery2 . A major cause of pain after cardiac surgery is the median sternotomy particularly on the first two postoperative days2 . Sternotomy, rib retraction, conduit harvest and drain tubes are some of the sources of pain in cardiac surgery1 . The most often used analgesics in these patients are parenteral opioids which can lead to undesirable respiratory depression, nausea and vomiting2Therefore,  we  are  planning  a  prospective, randomised, controlled, study on the efficacy and safety of infusing long-acting local anaesthetic drugs vs intermittent boluses of local anaesthetic administration into the median sternotomy wound in adult  patients  after  cardiac  surgery. we hypothesized that this intermittent bolus administration of local anaesthetic would significantly improve pain control as that of continuous infusion, as evidenced by the reduced need for postoperative systemic analgesic