Pecto-Intercostal Fascial Plane Block Study

Inclusion Criteria: * Participant provides consent to participate in study * Ideal body weight (IBW) is \>50kg * Participant is planned to undergo coronary artery bypass graft or single valve repair/replacement surgery via median sternotomy * Participant is undergoing an elective procedure Exclusion Criteria: * Participant is unable or unwilling to give consent * Non-English speaking * Known or believed to be pregnant or is currently breastfeeding * Participant is a prisoner * Clinically unstable per discretion of the Investigator * Participant requires urgent/emergent surgery * History of previous sternotomy * Preoperative coagulopathy (INR \>1.4, platelets \<100,000) or ongoing anticoagulation or anti-platelet therapy (except aspirin 81mg) * Allergy or sensitivity to amide-type local anesthetics, dexmedetomidine or ketamine * Participant has decompensated heart failure * Severe left ventricle dysfunction (defined quantitatively as an ejection fraction of less than or equal to 35%) or right ventricle dysfunction (defined qualitatively as "severe") * Diagnosis of cirrhosis or end-stage liver disease * Requires the use of mechanical circulatory support pre-operatively * Participant uses chronic opioids (meaning at the time of the preoperative screening evaluation by the study team, the patient is prescribed and taking any opioid pain medication)