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Pseudoephedrine and air travel-associated ear pain in children

B J Buchanan1, J Hoagland, P R Fischer

  • 1Department of Pediatrics, University of California, Davis, USA.

Insights

Pseudoephedrine hydrochloride did not reduce ear pain in children during air travel. This medication was associated with increased drowsiness in young travelers, highlighting the need for alternative strategies to manage in-flight ear discomfort.

Area of Science:

  • Pediatric medicine
  • Pharmacology
  • Aerospace medicine

Background:

  • Children frequently experience ear pain during airplane travel, particularly during ascent and descent.
  • Pseudoephedrine hydrochloride is effective for adults with recurrent ear pain during air travel, but its use in children remains unstudied.

Purpose of the Study:

  • To evaluate the effectiveness and safety of using pseudoephedrine hydrochloride as a preventive measure for ear pain in children during air travel.

Main Methods:

  • A placebo-controlled, double-blind clinical trial was conducted.
  • Participants included children aged 6 months to 6 years.
  • Pseudoephedrine hydrochloride (1 mg/kg) or a placebo was given 30–60 minutes before flights, with caregivers recording ear pain, drowsiness, and excitability.

Main Results:

  • Ear pain occurred in 14% of 91 flights involving 50 children, unrelated to prior history or recent infections.
  • Pseudoephedrine did not significantly decrease ear pain during ascent or descent compared to placebo.
  • Drowsiness was significantly more common with pseudoephedrine at takeoff (60% vs. 27% placebo, P = .003).

Conclusions:

  • In-flight ear pain is common in children on commercial flights.
  • Pre-flight administration of pseudoephedrine hydrochloride does not prevent ear pain in children during air travel.
  • Pseudoephedrine use in children is associated with an increased incidence of drowsiness.
Abstract

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