Application effect and sleep quality impact of multimodal analgesia (MMA) combined with Mindfulness-Based stress reduction (MBSR) therapy in Post-Spinal fusion surgery patients.

AIMS: We aim to investigate the clinical application effect of multimodal analgesia (MMA) combined with mindfulness-based stress reduction (MBSR) therapy in patients following spinal fusion surgery, analyze its impacts on post spinal-fusion surgery pain control, rehabilitation progress, and sleep quality, thereby providing evidence to inform comprehensive postoperative care protocols. METHODS: In this single-center, parallel-group randomized controlled trial, 124 patients were allocated 1:1 to an intervention group (MMA plus MBSR, n = 62) or a control group (conventional analgesia, n = 62) with concealed allocation and blinded outcome assessment. The results were compared between the two groups, including: pain intensity measured by the visual analogue scale (VAS) at 6 h, 12 h, 24 h, 48 h, and 72 h postoperatively; analgesic drug utilization (rate of use, number of rescue doses, duration of use); rehabilitation indicators (time to first ambulation, length of hospital stay, spinal function recovery score); sleep quality by the Pittsburgh Sleep Quality Index (PSQI); and psychological status evaluated by the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Cumulative opioid consumption expressed as oral morphine equivalents, adverse events, and treatment adherence were also recorded, and repeatedly measured outcomes were analyzed with linear mixed-effects models. RESULTS: Postoperative VAS scores were significantly lower in the intervention group at all measured time points (6 h, 12 h, 24 h, 48 h and 72 h) compared to the control group (all P < 0.001), with a significant group-by-time interaction (P < 0.001). The intervention group also demonstrated a lower rate of analgesic drug use, fewer rescue doses, and a shorter duration of analgesic use, together with lower cumulative oral morphine equivalents. Rehabilitation outcomes were superior in the intervention group, as evidenced by a shorter time to first ambulation, reduced hospital stay, and a higher spinal function recovery score. At one and two weeks postoperatively, PSQI scores were significantly lower in the intervention group. Furthermore, SAS and SDS scores at two weeks were lower in the intervention group compared to the control group. Adverse events were less frequent in the intervention group. CONCLUSION: In this single-center trial with short follow-up, the combination of MMA and MBSR therapy effectively alleviates postoperative pain, reduces analgesic use, enhances early rehabilitation and functional recovery, and improves sleep quality while mitigating anxiety and depression. However, because the design was not intended to separate the independent effects of MMA and MBSR, these findings require confirmation in multicenter trials.