The US loves to sedate. You guys get absolutely blasted when you have your wisdom teeth removed. In most of Europe you get strong pill painkillers for the first few days and then it’s paracetamol.

I don't know if you're expressing a common misconception here, but a lot of Americans also think general anaesthetic is widely used for wisdom teeth removal, and it isn't. What is widely used is deep sedation, a combination of ketamine and benzos which keeps the patient calm and, the nice part, prevents any memories of the event from forming. It's maybe an extra hour of recovery, same-day procedure in either case.

Post-care is a few day's worth of entry-level painkillers unless the patient gets a dry socket. We use acetaminophen for post-treatment rather than paracetamol, since it's better (never understood the British obsession with that stuff, it's nasty business).

Anywhere else I would walk away from a terrible joke like that, but this is HN. I'm joking.

You really got me there, was halfway through writing an angry reply when I read the last sentence.

I don't see the joke -- is this entire post untrue then?

Ah no. It hinges on paracetamol and acetaminophen being two names for the same analgesic. Everything but that sentence was perfectly serious.

It's also a rare joke where explaining it won't reduce the effect: by the time a Brit hits the end of the offending sentence, it's too late.

It depends on the situation. I had all of mine out this past weekend (in the US) and, because they were fully grown in, all they had to do was some local anaesthetic (about 8 shots around various parts of the mouth), wait 15 minutes, and loosen/pull them all. Total procedure was less than 30 minute and no painkillers prescribed after the fact.

> In UK sedation is rarely used unless specifically requested by the patient

It varies by hospital trust, there is no uniform guideline.

My local NHS hospital sedates for colonoscopy as a matter of course (using fentanyl). But as you say, some don’t, and others ask the patient.

Fair enough, I was told that this is standard practice

It is not due to cost, but profit. In the US the hospital makes more money if you get sedated. So why not offer, or even push it?

It's unnecessary but a lot of pain medication is "unnecessary." We use it to reduce pain because we don't like to feel pain. This seems self evidently common sense to me. In New Zealand my colonoscopies were carried out with ketamine, which is incredibly safe under medical supervision. Unless there are contraindicated medical conditions, I see no reason not to use something like ketamine or a light dose of oxygenated nitrous oxide.

In Poland they give you option for sedation, but advise against it because sedation disables the feedback from patient and that slightly increases the risk of complications. When they do the procedure they ask how you feel and when it gets too uncomfortable they change the angle etc.

I've had like a dozen of colonoscopies (have to be checked every year cause of risk factors), and they were never really painful.

Pain relief and sedation are two separate things.

Nitrous oxide is a fairly strong anagelsic (pain medication) but a very weak sedative. That's exactly why it's often used for minor routine procedures where keeping the patient awake and reasonably alert is more valuable than keeping the patient fully sedated.

Used a lot during birth here in the UK too

>>or a light dose of oxygenated nitrous oxide.

Which is what "gas and air" is in the context of my comment.