目的 研究亚甲蓝复合制剂近端肋间神经阻滞在开胸食管癌根治术中的应用效果,为开胸食管癌手术的近端肋间神经阻滞提供多种方案。方法 收集2022年6月—2023年12月行开胸食管癌手术治疗的120名患者作为研究对象,按随机数字表法分为对照组和试验组,每组各60例。对照组单纯采用全麻,试验组采用全麻联合亚甲蓝和罗哌卡因复合制剂近端肋间神经阻滞。记录两组患者手术时间、手术期间出血量;手术过程中低血压和心律失常的发生情况;术后胸部并发症（胸腔积液、肺部感染）情况;术后1、3、7、15 d,对患者进行视觉模拟评分法（VAS）评分。结果 两组患者在手术时间、手术期间出血量、手术过程中低血压和心律失常出现率方面,差异无统计学意义（P>0.05）;术后胸部并发症发生率和术后VAS评分方面,试验组均明显低于对照组,差异具有统计学意义（P<0.05）。结论 亚甲蓝复合制剂近端肋间神经阻滞在开胸食管癌根治术中可有效降低胸部并发症,并降低患者手术后的疼痛。

Objective To evaluate the efficacy of methylene blue compound for proximal intercostal nerve block during thoracotomy for radical resection of esophageal cancer, and to provide additional options for nerve block techniques in such procedures. Methods A total of 120 patients undergoing thoracotomy for radical resection of esophageal cancer from June 2022 to December 2023 were selected as study subjects and divided into a control group and an experimental group by random number table method, with 60 cases in each group. The control group received general anesthesia alone, while the experimental group received general anesthesia combined with methylene blue and ropivacaine for proximal intercostal nerve block. Operation time, blood loss during operation, the occurrence of hypotension and arrhythmia during surgery, and postoperative thoracic complications （such as pleural effusion and pulmonary infection） were recorded in the two groups. Postoperative pain was assessed using the visual analogue scale （VAS） 1, 3, 7, and 15 d after surgery. Results There were no significant differences in operation time, intraoperative blood loss, and the incidence of hypotension and arrhythmia during surgery between the two groups （P>0.05）. However, the incidence rates of postoperative thoracic complications and VAS scores in the experimental group were significantly lower than those in the control group （P<0.05）. Conclusion Methylene blue compound for proximal intercostal nerve block in thoracotomy for radical resection of esophageal cancer can effectively reduce thoracic complications and alleviate postoperative pain.