On the Challenges of Anesthesia and Surgery during Interplanetary Spaceflight

Abstract

This focused review summarizes the medical, logistical and environmental challenges that would be associated with dealing with a traumatic surgical case during an interplanetary space mission in the near future.

Anaesthetists and aerospace medicine in a new era of human spaceflight

“…In theory, an astronaut could be injured or develop a medical condition (‘become a patient’) requiring anaesthesia in space. This has not yet occurred but would present unique challenges, not least microgravity‐induced physiological changes such as a large head‐ward fluid shift, reduced blood volume and possibly cardiovascular deconditioning [1, 8]. The closed cabin environment is a contraindication to inhalational anaesthesia, while weightlessness complicates even routine technical procedures.…”

“…The closed cabin environment is a contraindication to inhalational anaesthesia, while weightlessness complicates even routine technical procedures. We have yet to answer the question of how best to provide anaesthesia in space [8], although multiple studies in the anaesthetic literature have investigated relevant techniques on parabolic aircraft flights that provide repeated ~20‐s periods of microgravity; for example, recent work supports the use of videolaryngoscopy for intubation in microgravity [9].…”

Anesthesia and Surgery in Space: Comment

“…We read the recent article penned by Komorowski et al . 1 with great interest, and we congratulate the authors on a well-composed and thought-provoking article addressing space exploration and the challenges of medical care, especially anesthesia, in this austere environment.…”

Anesthesia and Surgery in Space: Reply

“…As pointed out by Drs. Covington and Moon, 1 in response to our recent article, 2 mitigating the risk of decompression sickness is of utmost importance for future missions to the Moon or Mars. This risk is proportional to the ratio R between the partial pressure of nitrogen in the tissues and the pressure of the spacesuit.…”

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W e read the recent article penned by Komorowski et al 1 with great interest, and we congratulate the authors on a well-composed and thought-provoking article addressing space exploration and the challenges of medical care, especially anesthesia, in this austere environment.Although undersea and hyperbaric medicine is often associated with treating conditions secondary to increases in ambient pressure, such as those arising from scuba diving, it also aids in understanding and treating the pathophysiology 4. Wu X, Jiang Z, Ying J, Han Y, Chen Z: Optimal blood pressure decreases acute kidney injury after gastrointestinal surgery in elderly hypertensive patients: A randomized study: Optimal blood pressure reduces acute kidney injury.

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