Advantage of Tramadol in Local Analgesia Post-Sternotomy

Inclusion Criteria: * Persons who have provided written consent * Patients over 18 years old * Patients undergoing heart surgery via sternotomy: aortic valve surgery, mitral valve surgery, tricuspid valve surgery, atrial myxoma, coronary artery bypass graft, aorta surgery * Patients undergoing emergency or scheduled surgery Exclusion Criteria: * Adults under guardianship * Persons without national health insurance cover * Pregnant or breast-feeding women * Patients already included in the study once * Patients with aortic dissection * Patients with mediastinitis or sternal nonunion * Patients undergoing heart surgery for the second or more time * Patients with local infection or generalized bacteraemia-type infection * Patients with hypersensitivity to local anaesthetics or to tramadol or to opiates or to one of the excipients present in the products used * Patients with hypersensitivity to paracetamol or to paracetamol hydrochloride (prodrug of paracetamol) * Patients on antidepressants, gabapentin, pregabalin, neuroleptics * Patients with a history of convulsions or epilepsy * Patients with preoperative cognitive dysfunction * Patients with intracranial hypertension * Chronic use of morphines or high-dose steroid or non-steroid anti-inflammatory agents * Patients with acute or chronic kidney failure (creatininemia \> 170 µmol/L) * Patients with liver failure or porphyria * Patients under 17 years old * Patients with severe respiratory failure * Patients treated with a non-selective MAOI (iproniazid), a selective MAOI A (moclobemid, toloxatone), selective MAO-B inhibitor (Selegiline) or linezolid (Zyvoxid®) * Patients with acute intoxication or an overdose of products that depress the central nervous system (alcohol, hypnotics, other analgesics…) * Patients with severe hypotension