• Michael Kirsch, Shawn Brown, Brandon W Smith, Chang Kate W C KWC Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan., Sravanthi Koduri, and Yang Lynda J S LJS Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan..
• School of Medicine, University of Michigan, Ann Arbor, Michigan.
• Neurosurgery. 2020 Jun 1; 86 (6): 778-782.

BackgroundUnrealistic expectations of the outcomes of peripheral nerve surgery reduce patient satisfaction. Most clinicians can recall patients with unrealistic expectations despite verbal preoperative education.ObjectiveTo assess patients' baseline level of understanding regarding nerve surgery and appropriate expectations. Additionally, we tested the effect of a written, preoperative educational handout on the patients' retention of knowledge.MethodsThis cross-sectional survey recruited patients scheduled to undergo peripheral nerve surgery at a single institution in 2016 to 2017. During the preoperative visit, a specialized nurse practitioner reviewed perioperative protocols, risks and benefits of the surgery, and postoperative care. Patients immediately completed a survey to assess their preoperative understanding of the verbally reviewed information. During the same visit, an additional written handout was given to patients in a randomized fashion. At their first postoperative visit, all patients completed the survey again.ResultsA total of 60 patients (mean age 52 yr) were enrolled of which 62% were male. Immediately following verbal instruction, 31% of patients had erroneous (unrealistic) expectations regarding pain, 30% had erroneous expectations regarding postoperative motor outcome, and 41% had erroneous expectations regarding the timing of postoperative recovery. There was no significant difference between patients who received the written handout vs those who did not, on retesting in the postoperative period.ConclusionPatients undergoing peripheral nerve procedures demonstrated a high baseline level of unrealistic expectations despite standard in-person verbal counseling by specialty providers. A written handout did not have clear benefit in the retention of preoperative surgical teaching. Further investigation into more effective preoperative patient counseling is needed.Copyright © 2019 by the Congress of Neurological Surgeons.

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