{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T17:01:24Z","timestamp":1784998884374,"version":"3.55.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The recent global shortage of sterile saline highlighted a lack of published information and guidance regarding the components used in tumescent anaesthesia (TA) for endovenous interventions of venous disease. The aim of this study was to identify current practices in the usage of TA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online survey was sent to members of the Australasian College of Phlebology and the mailing list of the International Union of Phlebology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>87 medical practitioners either partially or fully completed the survey, with the majority of respondents being Phlebologists (54%). The vast majority of survey participants use lignocaine (92.5%), adrenaline (55%), sodium bicarbonate (67.1%) in a base fluid of sterile normal saline (90.8%) in the preparation of TA. The majority of administration was through mechanical pumps (68.1%), with 27.8% using syringes. 21.7% reported reusing the same tumescent bag for more than one patient. Only 36.2% obtained consent specifically for TA. Two thirds recorded the anaesthetic dose, as mg\/kg (23.5%), or total dose (45.6%) Only 40.6% of participants reported storing intralipid. 7.9% of respondents in this survey had experienced Local Anaesthetic Systemic Toxicity, with one death reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The survey identified some variability in the volume of components used, and considerable variability in consenting practices, documentation, patient observations, the storage of Intralipid and the re-use of single use intravenous fluid bags between patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555261470981","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:31:59Z","timestamp":1784781119000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tumescent anaesthesia for endovenous interventions - a survey of medical practitioners"],"prefix":"10.1177","author":[{"given":"Emma","family":"Dabbs","sequence":"first","affiliation":[{"name":"St Vincent\u2019s Centre for Applied Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha R.","family":"Siriwardene","sequence":"additional","affiliation":[{"name":"St Vincent\u2019s Centre for Applied Medical Research"},{"name":"St Vincent\u2019s Hospital"},{"name":"University of New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9602-7213","authenticated-orcid":false,"given":"David E.","family":"Connor","sequence":"additional","affiliation":[{"name":"St Vincent\u2019s Centre for Applied Medical Research"},{"name":"University of New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Benson","sequence":"additional","affiliation":[{"name":"Skin Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Amos","sequence":"additional","affiliation":[{"name":"Concord Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0630-8877","authenticated-orcid":false,"given":"Kurosh","family":"Parsi","sequence":"additional","affiliation":[{"name":"St Vincent\u2019s Centre for Applied Medical Research"},{"name":"St Vincent\u2019s Hospital"},{"name":"University of New South Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.12.024"},{"key":"e_1_3_6_3_2","volume-title":"Clinical guideline [CG168]. Varicose veins: diagnosis and management","author":"National Institute for Health and Clinical Excellence","year":"2013","unstructured":"National Institute for Health and Clinical Excellence. Clinical guideline [CG168]. Varicose veins: diagnosis and management. National Institute for Health and Clinical Excellence, 2013. https:\/\/www.nice.org.uk\/guidance\/cg168"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000082811.60648.A4"},{"key":"e_1_3_6_5_2","first-page":"45","article-title":"Thermometric investigations of the perivenous temperature during endovenous laser therapy of varicose veins","volume":"24","author":"Lahl W","year":"2005","unstructured":"Lahl W. Thermometric investigations of the perivenous temperature during endovenous laser therapy of varicose veins. Int Angiol 2005; 24: 45\u201350.","journal-title":"Int Angiol"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355516653905"},{"key":"e_1_3_6_7_2","unstructured":"Pfizer. Ropivacaine hydrochloride. https:\/\/www.pfizer.com\/products\/product-detail\/ropivacaine_hydrochloride (accessed 18 October 2024)."},{"key":"e_1_3_6_8_2","unstructured":"Pfizer. Marcaine. https:\/\/www.pfizer.com\/products\/product-detail\/marcaine (accessed 18 October 2024)."},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2024.1359474"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.02.010"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355519836834"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2014.07.006"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2012.12.009"},{"key":"e_1_3_6_14_2","first-page":"709","article-title":"ASDS guidelines of care for tumescent liposuction","volume":"32","author":"Svedman KJ","year":"2006","unstructured":"Svedman KJ, Coldiron B, Coleman WP, et al. ASDS guidelines of care for tumescent liposuction. Dermatol Surg Off Publ Am Soc Dermatol Surg Al 2006; 32: 709\u2013716. https:\/\/doi.org\/10.1111\/j.1524-4725.2006.32159.x","journal-title":"Dermatol Surg Off Publ Am Soc Dermatol Surg Al"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1996.tb00634.x"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.4103\/JCAS.JCAS_192_19"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1734-1140(09)70116-1"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/37.6.394"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.1997.0293"},{"key":"e_1_3_6_20_2","unstructured":"Medical Board of Australia. Good medical practice: a code of conduct for doctors in Australia. https:\/\/www.medicalboard.gov.au\/Codes-Guidelines-Policies\/Code-of-conduct.aspx (accessed 22 December 2025)."},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2014.10.028"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.05.017"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1258\/phleb.2011.011026"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355513512827"},{"key":"e_1_3_6_25_2","first-page":"651","article-title":"Effect of temperature for tumescence anesthesia solution on intraoperative and postoperative pain of endovenous laser ablation of lower extremity varicose vein","volume":"43","author":"Luo L","year":"2018","unstructured":"Luo L, Chen Z, Xiao E, et al. Effect of temperature for tumescence anesthesia solution on intraoperative and postoperative pain of endovenous laser ablation of lower extremity varicose vein. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018; 43: 651\u2013655. https:\/\/doi.org\/10.11817\/j.issn.1672-7347.2018.06.012","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2013.11.015"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1708538113518532"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mku027"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000720"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.22643"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101986"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_113_17"},{"key":"e_1_3_6_33_2","first-page":"1","article-title":"Intravenous solution bags are designed for single use only","volume":"8","author":"Therapeutic Goods Administration (TGA)","year":"2017","unstructured":"Therapeutic Goods Administration (TGA). Intravenous solution bags are designed for single use only. Med Saf Update 2017; 8: 1.","journal-title":"Med Saf Update"}],"container-title":["Phlebology: The Journal of Venous Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555261470981","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02683555261470981","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555261470981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T16:20:50Z","timestamp":1784996450000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02683555261470981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":32,"alternative-id":["10.1177\/02683555261470981"],"URL":"https:\/\/doi.org\/10.1177\/02683555261470981","relation":{},"ISSN":["0268-3555","1758-1125"],"issn-type":[{"value":"0268-3555","type":"print"},{"value":"1758-1125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"02683555261470981"}}