Group (A): This group will receive fentanyl infusion at a dose of (0.5μg/kg/h) all through the whole operation plus ultrasound guided bilateral superficial parasternal intercostal Plane block which will be done by injecting 0.4ml/kg (1:1 solution of bupivacaine 0.25% and lidocaine 1%) at each side3.
Group (B): This group will receive fentanyl infusion at a dose of (0.5μg/kg/h) all through the whole operation plus Ultrasound guided bilateral ESPB which will be done by injecting 0.4ml/kg (1:1 solution of bupivacaine 0.25% and lidocaine 1%) at each side .
RACHS-1: Categories 1, 2 and 3
Patients undergoing corrective cardiac surgeries with midline sternotomy incision.
Redo surgeries.
Patients whose parents or legal guardians refuse to participate.
Preoperative mechanical ventilation.
Preoperative inotropic drug infusion.
Coagulopathy.