Effects of transcutaneous scopolamine and depth on diver performance

Transdermal scopolamine is an effective anti-motion-sickness medication that has less CNS side effects at normal ambient pressure than orally ingested agents. To see whether it has an effect on performance at depth, 24 healthy sport divers were exposed to depths equivalent to 5 m (1.5 ATA) and 36 m (4.8 ATA) in a dry recompression chamber, breathing air and wearing a skin patch containing either scopolamine or inactive placebo. Patches and dive depths were presented in a counterbalanced, double-blind experimental design. Tests of sentence comprehension, simple arithmetic, and manual dexterity were used to evaluate psychometric and cognitive performance. Drug side effects were recorded. The Bennett Hand Tool Dexterity Test was evaluated for its suitability for repeated measures testing, and found to be robust. Manual dexterity and sentence comprehension were significantly impaired at depth whereas arithmetic skills were not. No significant effects on diver performance from transdermal scopolamine were seen. Certain side effects such as blurred vision were more common with scopolamine than with placebo. The use of transdermal scopolamine as an antiemetic during diving operations deserves field evaluation.