Nociception testing during fixed-wing ambulance flights. An interventional pilot study on the effects of flight-related environmental changes on the nociception of healthy volunteers

PLoS One. 2020 Feb 24;15(2):e0217530. doi: 10.1371/journal.pone.0217530. eCollection 2020.


Background: The effects of environmental changes on the somato-sensory system during long-distance air ambulance flights need to be further investigated. Changes in nociceptive capacity are conceivable in light of previous studies performed under related environmental settings. We used standardized somato-sensory testing to investigate nociception in healthy volunteers during air-ambulance flights.

Methods: Twenty-five healthy individuals were submitted to a test compilation analogous to the quantitative sensory testing battery-performed during actual air-ambulance flights. Measurements were paired around the major changes of external factors during take-off/climb and descent/landing. Bland-Altman-Plots were calculated to identify possible systemic effects.

Results: Bland-Altman-analyses suggest that the thresholds of stimulus detection and pain as well as above-threshold pain along critical waypoints of travel are not subject to systemic effects but instead demonstrate random variations.

Conclusions: We provide a novel description of a real-life experimental setup and demonstrate the general feasibility of performing somato-sensory testing during ambulance flights. No systematic effects on the nociception of healthy individuals were apparent from our data. Our findings open up the possibility of future investigations into potential effects of ambulance flights on patients suffering acute or chronic pain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Ambulances*
  • Air Travel
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Nociception*
  • Nociceptive Pain / etiology*
  • Pain Threshold
  • Travel-Related Illness*

Grants and funding

This study was funded by a science grant from the ADAC Schutzbrief AG. Open Access publication fees were provided by the Friedrich-Alexander University of Erlangen-Nuremberg. Sponsors did not play any role in study design, data collection, analysis and interpretation or preparation of the manuscript.