Eligibility criteria {10}
pain, Psychiatric disorders, myxoma, allergies, atrial septal defect
SYSTEMIC INFECTION, DIABETIC NEUROPATHY, CHRONIC RENAL DISEASE, MYXOMA, ALLERGIES, VALVULAR HEART DISEASE, CHRONIC PAIN SYNDROME
Adult patient with an American Society of Anesthesiologist (ASA) physical status I-III, aged 18–80 years, scheduled for elective minimal invasive cardiac surgery, e.g., mitral valve procedures, tricuspid valve procedures, myxoma resection, or atrial septal defect repair. All participants will undergo the usual standard medical work-up before, during, and after the procedure according to the ESC/EACTS Guidelines on Valvular Heart Disease [This includes echocardiography, spirometry, carotid artery duplex scan, cardiac MRI, and/or computed tomography, and interviews with the cardiologist, cardiac surgeon, and anesthesiologist.To be eligible for this study, patients must meet all of the following criteria:Age: 18–80 years.BMI 18–35 kg/m.Informed consent.MICSThe exclusion criteria are as follows:Known allergies to administered drugs.Severe diabetic neuropathy.LV-dysfunction (EF < 30%).Drug-opioid abuse.Patients with chronic pain syndrome.Systemic infection.Psychiatric disorders that lead to alteration in the perception and evaluation of pain.Pregnancy.Anticipated endotracheal intubation > 24 h.eGFR < 30 or chronic renal disease.