Perioperative communication is commonly assessed through documentation and patient-reported adequacy, although these measures may not indicate whether clinically relevant instructions are recalled. This study addressed three questions: (1) does patient-reported adequacy reflect immediate recall of a key postoperative instruction after carpal tunnel release; (2) which patient- or process-related factors are associated with incorrect immediate recall; and (3) is incorrect immediate recall associated with early postoperative outcomes?

The proportion of patients reporting adequate information would exceed the proportion demonstrating correct immediate recall, and patient-reported adequacy would have limited ability to identify patients with incorrect recall.

This prospective observational study included a pragmatic convenience sample of adults undergoing isolated ambulatory minimally invasive carpal tunnel release between January 2023 and March 2024. All patients followed a standardised surgical and anaesthetic pathway and received the same key postoperative instruction: use of the operated hand could begin immediately. Approximately 10 min later, before discharge explanations were provided, patients completed a study-specific digital questionnaire assessing perceived information adequacy, identification of the surgeon and anaesthetist, and immediate recall of the instruction. Associations with incorrect recall were examined using multivariable logistic regression. Postoperative pain, unexpected patient-initiated contacts, complications, sick-leave extension and supervised hand therapy were assessed exploratorily for up to 3 months.

Of 406 patients approached, 385 were analysed. Information provided during the surgical consultation was considered adequate by 381/385 patients (99.0%), whereas 326/385 (84.7%) correctly recalled the postoperative instruction, an absolute difference of 14.3 percentage points. Among patients reporting adequate information, 58/381 (15.2%) nevertheless had incorrect immediate recall. Correct identification of the anaesthetist was independently associated with lower odds of incorrect recall (adjusted OR 0.45, 95% CI 0.25–0.80; p = 0.007). Age, sex, surgeon identification and perceived clarity of postoperative recommendations were not independently associated with recall. No statistically significant differences in exploratory postoperative outcomes were detected according to recall status; event numbers were low.

Consistent with previous evidence of incomplete patient recall after perioperative information, patient-reported adequacy should not be considered a surrogate for immediate recall. Within this standardised ambulatory pathway, perceived adequacy and immediate recall represented distinct dimensions of perioperative communication. Brief objective recall assessment may complement existing quality indicators in ambulatory surgery and warrants evaluation in future intervention studies.

IV; prospective observational study without a control group.