MINI REVIEW article
Front. Physiol.
Sec. Environmental, Aviation and Space Physiology
Physiologic Changes in Microgravity May Lead to Unpredictable Effects of Spinal Anesthesia
Provisionally accepted
Siobhan Wagner1
Matthew Turnock2*- 1University of Toronto, Toronto, Canada
- 2University of British Columbia, Vancouver, Canada
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Regional techniques such as spinal anesthesia may offer advantages over general anesthesia for autonomous medical care during long-duration space missions, yet their behaviour in microgravity remains largely uncharacterised. On Earth, intrathecal anesthetic spread depends on baricity, posture, spinal curvature, and cerebrospinal fluid dynamics. Microgravity alters these determinants by diminishing gravity-dependent density gradients, modifying spinal geometry through paraspinal atrophy and elongation, and inducing cardiovascular and neurophysiologic adaptations that may affect block characteristics and hemodynamic tolerance. This Mini Review synthesises current evidence on spinal anesthetic mechanisms and spaceflight physiology to identify where terrestrial assumptions may fail in microgravity. Key knowledge gaps and research priorities are highlighted to inform the development of safe neuraxial anesthesia protocols for exploration-class missions.
Keywords: Baricity, Cerebrospinal Fluid, Hemodynamics, intrathecal drug spread, microgravity, space medicine, spaceflight, spinal anesthesia
Received: 22 Dec 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Wagner and Turnock. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Matthew Turnock
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