Regional anesthesia for the management of limb injuries in space

Traumatic injuries continue to present a threat to the success of current and future spaceflight missions. The magnitude of this threat will grow as the frequency of extravehicular activities is increased and missions venture beyond low Earth orbit and further away from terrestrial medical support. The capability to render definitive treatment to crewmembers who suffer a serious traumatic injury while in space is relatively limited at present. While some research has focused on the development of specific surgical techniques for the microgravity environment, little attention has been given to how one might practically provide anesthetic care for injured crewmembers expected to undergo these procedures. While many logistical and practical obstacles exist to the provision of general anesthesia in microgravity, regional anesthesia could be used to overcome many of these problems. A regional anesthetic capability for spaceflight missions could be developed with minimal modifications to existing terrestrial techniques and would provide the ability to manage a wide range of potential injuries while in orbit. The capability to provide reliable regional anesthesia could be further augmented and improved using a range of imaging technologies currently in development; it is expected that these devices would have a range of terrestrial applications, including the ability to provide immediate, safe, and reliable anesthetic care to patients in remote locations, or under austere conditions such as the combat environment.