Comparison of the Postoperative Analgesic Effectiveness of Erector Spinae Plane Block Versus Its Combination With Superficial Parasternal Intercostal Plane Block Within the ERACS Program

Inclusion Criteria * Patients scheduled for elective cardiac surgery via median sternotomy under the ERACS protocol * Age between 18 and 80 years * ASA physical status II-III * Body Mass Index (BMI) between 18 and 35 kg/m² * No cognitive impairment (able to cooperate and follow commands) * No history of chronic pain or regular analgesic use * Provided written informed consent after detailed explanation of the study Exclusion Criteria * Age \< 18 years or \> 80 years * ASA physical status ≥ IV * Emergency surgery * Pregnant or breastfeeding women * Redo coronary artery bypass surgery * Pre-existing cognitive disorder or psychiatric illness affecting pain or delirium evaluation * Infection or skin lesion at the injection site * Known allergy or hypersensitivity to local anesthetics (bupivacaine or amide type) * Chronic pain or opioid use prior to surgery * Unwillingness to participate or withdrawal of consent at any stage