Objective To compare the effects of ultrasound‑guided bilateral transversus thoracic muscle plane block (TTPB) and parasternal nerve block (PSB) on sufentanil dose during off‑pump coronary artery bypass grafting (OPCABG). Methods One hundred and fifty patients who underwent OPCABG at the General Hospital of the Northern Theater Command were divided into a control group (group C), TTPB group (group T), and PSB group (group P) using a random number table method, with 50 patients in each group. Group C underwent target controlled infusion (TCI) with total intravenous anesthesia, while group T underwent bilateral TTPB first and then TCI with total intravenous anesthesia,and group P underwent bilateral pectoralis major and intercostal muscles were first blocked under ultrasound guidance and then TCI with total intravenous anesthesia. The total amount of sufentanil used during the operation and after entering the operating room (T0), when the consciousness of anesthesia induction disappears (T1), immediately after tracheal intubation (T2), 3 minutes after tracheal intubation (T3), skin incision (T4), 1 minute after sternum (T5), pericardiotomy (T6), before partial occlusion of aortic side wall clamp (T7), after opening of side wall clamp (T8), 5 minutes after reperfusion (T9), when closing the chest (T10), at the end of surgery (T11), the effective concentration of sufentanil, mean arterial pressure (MAP), heart rate, and positive inotropic drug score were recorded at the three groups of patients. Measure the plasma levels of IL‑6 and C‑reactive protein (CRP) were detected 24 h before operation, 24, 48, 72 h after operation. Blood gas analysis was used to detect blood glucose and lactate levels at T0, T3, T6, T11 and 2, 4, 6, 8, 16, 24 h after operation. The Visual Analogue Scale (VAS) scores at rest and exercise state at 24 h and 48 h after operation, the number of additional analgesics on the day after operation, the first day after operation, and the second day after operation, and the occurrence of adverse reactions (shivering, nausea and vomiting, dizziness, respiratory depression, infection at the puncture site, hematoma at the puncture site) within 3 days after operation were recorded. Results The total amount of sufentanil used during operation, the concentration of sufentanil effect at T3‒T11, MAP at T2 and T10, VAS scores at rest and exercise 24 h after operation, the percentage of patients with additional analgesics on the day after operation, blood glucose level at 2, 4, 6, 8 h after operation, lactic acid level at T11 and 2, 4, 6 h after operation, IL‑6 level at 24 h and 48 h after operation, CRP level at 48 h after operation, and the incidence of shivering within 3 days after operation in group T and group P were lower than those in group C (P<0.05), and the dosage of sufentanil, effective concentration of sufentanil at T5‒T11, and postoperative 24 h resting and exercise VAS scores in group T were lower than those in group P (P<0.05). Compared with T0, the blood glucose levels in the three groups of patients increased at T6, T11 and 2, 4, 6, 8, 16, 24 h after surgery (P<0.05). The lactate levels increased at T11 and 2, 4, 6 h and 8 h after surgery in group C (P<0.05), while the lactate levels increased at 2, 4, 6 h and 8 h after surgery in group T and P (P<0.05). Compared with 24 h before surgery, the levels of IL‑6 and CRP in the three groups of patients increased at 24 h and 48 h after surgery (P<0.05). There was no statistically significant difference in other indicators (P>0.05). Conclusions Ultrasound guided TTPB and PSB have good analgesic effects during OPCABG surgery, stabilize intraoperative hemodynamic fluctuations, and to some extent suppress stress and inflammatory reactions, which is beneficial for postoperative recovery of patients. And TTPB has better analgesic effects than PSB.