Airsickness treatment and prevention: Recommendations regarding antiemetics and/or acustimulation

Abstract

Airsickness has been an important concern for aviation since before World War II. Airsickness is still a topic of serious discussion in the aviation community, despite recent advances in medical science, aircraft engineering and performance. Symptoms of motion sickness range from mild to incapacitating in nature and can cause degradation in performance measures of reaction time, postural stability and cognitive functioning. This can result in unacceptable work force losses, incur significant costs, and ultimately result in mission compromise and/or missing critical objectives. Current pharmacological interventions may produce side effects such as sedation and diminished cognition. \r\nAcustimulation at the median P6, or Neiguan, point has recently generated interest as a non-pharmacological means of preventing motion sickness. A recent study evaluating a popular acupressure wristband reported it to be effective in the suppression of the major symptoms (nausea and vomiting) of motion sickness. This study concluded that continuous vigorous stimulation of the P6 point was required to achieve a significant benefit. \r\nThe commercially available Reliefband® provides electrical acustimulation at the P6 point thereby reportedly countering symptoms of chemotherapy-induced nausea and vomiting. Its makers market it as “the only FDA-cleared device for motion sickness”. A literature search revealed that no published studies comparing currently available pharmacologic and non-pharmacologic (Reliefband®) motion sickness treatments in conjunction with rotary wing operations are available. \r\nThis capstone describes a randomized, double blind, cross over study comparing the effectiveness of four airsickness countermeasures to a placebo control and to each other on reaction time, postural stability, and cognition in relation to airsickness symptom severity and their ability to ameliorate performance declines following simulated rotary wing combat operations. The data suggest that only the combination of phenergan with caffeine was effective in achieving these measures. This study will help enable the aerospace medical community to make recommendations to military commanders and civilian policy makers concerning the ability of viable treatments to mitigate performance decrements seen because of rotary wing flight induced motion sickness. \r\n