For the second time in the series, The Doctor is the only one left on Voyager that can do anything, and other crew members are off-ship. The first time was Macrocosm (1996) when the crew was incapacitated.
The story for this two-part episode bears striking similarities to the Stargate SG-1 (1997) episode, Beneath the Surface (2000), which aired a few months earlier. Both are inspired by the silent film Metropolis (1927).
Harry and Neelix refer to their away mission in which they encountered the "Nar Shaddans." In the expanded Star Wars Universe, Nar Shaddaa is the largest moon of Nal Hutta, home planet of the Hutts.
The natives of the planet are called Quarrens, which is another Star Wars name. The Star Wars Quarrens are squid-faced people.