Inclusion Criteria:  Undergoing elective cardiac surgery for coronary artery bypass graft (CABG) or valve surgery via sternotomy. English speaking  Exclusion Criteria:  Emergency surgery Allergy to medications (ie lidocaine) BMI less than 20 or greater than 35 Major liver or kidney dysfunction or other pre-existing major organ dysfunction Revision cardiac surgery Surgery via thoracotomy Off-pump coronary artery bypass Narcotic dependent (Opioid intake morphine equivalents greater than 10mg/day for more than 3 months Chronic pain (ie fibromyalgia) Significant central nervous system or respiratory disease Hematological disorders or de-ranged coagulation parameters Psychiatric illness that impedes subject from providing informed consent Pre-operative neurological deficits Language barrier Inability to provide informed consent Prisoner status Pregnancy