Training Non-Anesthesia Personnel to Perform Nerve Blocks in Microgravity

Space exploration is rapidly progressing with multiple upcoming missions planned to the moon and International Space Station, and projected missions to Mars in the early 2030s. Multiple types of injuries and surgical emergencies are possible during space travel. With the rapidly increasing number of travelers, healthcare providers need to refine our plans for responding to surgical emergencies in space. It may not be possible to return injured crew members to earth for medical treatment depending on distance from earth and the severity of the injury. Furthermore, the casualty's physiologic changes in microgravity, and logistical limitations of repatriation make addressing medical emergencies challenging. Pain medications and general anesthesia have side effects that can impact safety in space and have worse side effect profiles when compared to on earth. Regional anesthesia, injecting local anesthetic near to a nerve(s) to create a large area of numbness on the body, has been used for many years for pain management and to allow for surgery in remote settings on earth. Military personnel have used these techniques to provide effective pain control for evacuating wounded soldiers, while maintaining their cognition. For these reasons, regional anesthesia (aka 'nerve block') has been promoted as a viable solution for injured astronauts. Our team has demonstrated that simple nerve blocks are possible in simulated microgravity among trained anesthesia providers. Recognizing that non-physician medical technicians may be integral to future space missions, this study aims to ascertain the feasibility of training such personnel to perform simple nerve blocks in microgravity.

Inclusion Criteria for the non-anesthesia group: * adult (age \>18 years) * certified scuba divers * no prior nerve block technique training. Inclusion criteria for the anesthesia group: * staff anesthesiologists or senior residents * certified scuba divers Exclusion Criteria: * active ear nose and throat conditions that prevent ear equalization * neuromotor conditions interfering with fine motor skills * pregnancy * inability to consent