by Wayne Gradman, M.D.

1. A wedge or blanket under the contralateral hip helps your patient maintain eversion of the treated leg for an extended time

2. A warm blanket is my favorite way to dilate the venous system. Use a heating blanket to heat the blankets you put on the patient before you start. A generous dollop of Nitropaste at the entry site can be of additional help

3. Splurge for a tumescent infiltration pump. It makes administering tumescent anesthesia a breeze. Be generous with anesthetic (200-300cc/thigh length).

4. Stay a small distance from the saphenous vein when infusing tumescent anesthesia into the saphenous fascial compartment. It is possible to infuse the solution into the vein rather than around it.

5. Learn to use shadowing artifact to determine the location and orientation of the sheath.