关键词: 前交叉韧带重建术, 多模式镇痛, 健康赋权理论, 疼痛, 负性情绪, 自我护理能力

Abstract:

Objective To analyze the effects of multimodal analgesia combined with health empowerment theory nursing on pain， hemodynamics and negative emotions of patients after anterior cruciate ligament reconstruction （ACLR）. Methods A total of 122 patients who underwent ACLR in the First Affiliated Hospital of Nanjing Medical University from February 2025 to February 2026 were selected as the study subjects. They were divided into the control and study groups by random number table method， with 61 cases in each group. The control group was given routine analgesia combined with routine nursing program， and the study group was given multimodal analgesia combined with health empowerment theory nursing on the basis of the control group. Both groups were intervened until discharge and followed up for 2 months. The cumulative dosage of sufentanil during operation， the rescue rate of analgesic drugs at 24 h after operation， the hospitalization time， the hemodynamics after entering the operating room， at the end of operation and at extubation， the pain degree at 6， 12 and 24 h after operation， the negative emotion and self-care ability before operation and 2 months after operation， and the compliance of rehabilitation exercise at 2 months after operation， the nursing satisfaction at discharge and the postoperative safety were compared between the two groups. Results Compared with the control group， the cumulative dosage of sufentanil in the study group was less， and the rescue rate of analgesic drugs at 24 h after operation was lower （P < 0.05）. From entering the operating room to extubation， the heart rate， systolic blood pressure and diastolic blood pressure of the two groups decreased first and then increased， and those of the study group were lower than the control group， and the increase of heart rate， systolic blood pressure and diastolic blood pressure at extubation in the study group was lower than that at the end of operation （P < 0.017 after correction）. The scores of numerical rating scale （NRS） of the study group at 6， 12 and 24 h after operation were lower than those of the control group （P < 0.017 after correction）. Compared with before operation， the scores of self-rating depression scale （SDS） and self-rating anxiety scale （SAS） at 2 months after operation in the two groups decreased， the study group was lower； the score of self-care ability measurement scale （ESCA） of the two groups increased， the study group was higher （P < 0.05）. Compared with the control group， the scores of active learning， psychological and physical exercise compliance in the study group were higher at 2 months after operation （P < 0.05）. There was no significant difference in the rate of nursing satisfaction between the two groups at discharge （100.00% vs. 95.08%， P > 0.05）. There was no significant difference in the incidence of postoperative nausea and vomiting between the two groups （3.28% vs. 8.20%， P > 0.05）， and no serious adverse events such as respiratory depression and nerve block-related complications occurred in the two groups. Conclusions The multimodal analgesia combined with health empowerment theory nursing could reduce the amount of opioids used during operation and the need for postoperative remedial analgesia in patients with ACLR， reduce postoperative pain and stabilize perioperative hemodynamics. At the same time， it could relieve patients negative emotions， improve self-care ability and rehabilitation exercise compliance， and the nursing satisfaction and safety was good.

Key words: anterior cruciate ligament reconstruction, multimodal analgesia, health empowerment theory, pain, negative emotions, self-care ability