Heart surgery without morphine: safer or not?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Patients having planned cardiac surgery under cardiopulmonary bypass, with at least one coronary artery bypass grafting and rf at least one internal mammary artery as graft; possible association with aortic valve replacement * Patient having red and understood the information letter and signed the consent form * For women : of childbearing age, need to confirm the absence of an active pregnancy by a negative blood pregnancy test within 48 hours prior to inclusion / menopausal (amenorrhea not medically induced for at least 12 months before the inclusion visit) * Patient affiliated to a social security scheme Exclusion Criteria: * Preoperative treatment with morphine or its derivatives (including tramadol) in the 15 days preceding the inclusion visit * Pre-existing high-degree conduction disorder * Bradycardia \< 50 bpm * Oxygen therapy prior to inclusion * Heart failure with LVEF \<40% * BMI ≥ 35 kg/m² * Myocardial suffering in the 5 days preceding inclusion * Patient in shock * Known adrenal insufficiency and / or long-term systemic corticosteroid treatment (equivalent to hydrocortisone hemisuccinate ≥ 20 mg / day) * Combined surgery other than aortic valve * Long-term non-invasive ventilation (including for obstructive sleep apnea syndrome) * Any antecedent or active practice (s) of drug addiction; * Contraindication to one of the experimental and / or non-experimental treatments: dexmedetomidine, lidocaine, dexamethasone, ketamine, remifentanil or morphine * Acute cerebrovascular pathology, * Severe hepatic insufficiency (factor V level \<50%), * Pre-existing cognitive disorders, * Patient for whom the CAM-ICU questionnaire cannot be carried out (deaf patients for example), * Pregnant or parturient or breastfeeding woman * Person deprived of liberty by an administrative or judicial decision or person placed under judicial protection / under guardianship or guardianship * Patient participating in another drug trial or having participated in another drug trial within 1 month before randomization