Effects of midazolam combined with sufentanil on injury and expression of HMGB1 and NF-κB in rats with pancreatitis

OBJECTIVE: Midazolam and sufentanil are common analgesic and sedative drugs, but the effects and mechanisms of the combination of these two drugs on pancreatitis injury have not been fully elucidated. MATERIALS AND METHODS: Rats pancreatitis model were randomly divided into 4 groups, model group, midazolam group, sufentanil group, and combined group, followed by an analysis of the general indicators, the onset time, duration, analgesic time, and adverse reactions, as well as pancreatic serological indicators. In addition, the level of the serum TNF-alpha and IL-1 beta was detected by enzyme-linked immunosorbent assay (ELISA), and the reactive oxygen species (ROS) production was assessed by spectrophotometer, together with an analysis of the superoxide dismutase (SOD) activity and the expression of HMGB1 and NF-kappa B mRNA in pancreatic tissue by Real Time-PCR. RESULTS: Midazolam alone or in combination with sufentanil improved the general indicators along with long duration of sedative analgesia, reduced serum TNF-alpha, and IL-1 beta secretion and few adverse reactions. Meanwhile, the expression of HMGB1 and NF-kappa B was reduced and the pancreatic serum markers and ROS production were decreased with increased SOD activity. Compared with the model group, the differences were statistically significant (p<0.05), with more significant changes in the combined group (p<0.01). CONCLUSIONS: Midazolam combined with sufentanil can inhibit the expression of HMGB1 and NF-kappa B, inhibit inflammation, thereby improving the sedative and analgesic effects, protecting pancreatic tissue, and reducing acute pancreatitis injury.