Effects of preoperative neurobiological education on postoperative outcome: A systematic review

Abstract

Background: Pain may have a crucial impact on human quality of life. An increase in knowledge about neurobiological and neuroscientific processes alone can positively influence the subjective perception of pain as well as psychometric variables. There are different forms of preoperative patient education with the aim to explain postoperative pain. Based on current literature, preoperative biomedical education has a low level of evidence. It can increase the preoperative anxiety and stress level of patients, which has a negative impact on the postoperative outcome. In contrast, the neuroscientific understanding considers postoperative pain from the viewpoints of the plasticity of the nervous system and involves sensitizational processes in the central and peripheral nervous systems. Purpose: To systematically investigate short- and long-term effects of pain neuroscience education (PNE) in patients before spine surgery. Materials and methods: The literature search involved a search of medical databases according to the PI(C)O scheme, and 83 articles were shortlisted. Nine articles that met the inclusion and exclusion criteria were finally included. Results: Preoperative pain neuroscience education can positively influence postoperative catastrophizing tendencies as well as postoperative kinesiophobia but has no influence on postoperative pain and function. Conclusion: Preoperative reduction of anxiety and pain-maintaining factors mainly on the psychological and social level may have a positive effect on postoperative subjective pain evaluation, which is reflected in a reduction of anxiety, catastrophizing tendencies, and a lower utilization of postoperative health care services.