Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
Eur Rev Med Pharmacol Sci. 2020 Feb;24(4):2102-2109. doi: 10.26355/eurrev_202002_20390.
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.
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-α and IL-1β 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-κB mRNA in pancreatic tissue by Real Time-PCR.
Midazolam alone or in combination with sufentanil improved the general indicators along with long duration of sedative analgesia, reduced serum TNF-α, and IL-1β secretion and few adverse reactions. Meanwhile, the expression of HMGB1 and NF-κB 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).
Midazolam combined with sufentanil can inhibit the expression of HMGB1 and NF-κB, inhibit inflammation, thereby improving the sedative and analgesic effects, protecting pancreatic tissue, and reducing acute pancreatitis injury.
咪达唑仑和舒芬太尼是常用的镇痛和镇静药物，但这两种药物联合应用对胰腺炎损伤的作用和机制尚未完全阐明。
将胰腺炎模型大鼠随机分为 4 组，即模型组、咪达唑仑组、舒芬太尼组和联合组，然后分析一般指标、起效时间、持续时间、镇痛时间和不良反应，以及胰腺血清学指标。此外，通过酶联免疫吸附试验（ELISA）检测血清 TNF-α和 IL-1β水平，通过分光光度计评估活性氧（ROS）的产生，并通过 Real Time-PCR 分析胰腺组织中超氧化物歧化酶（SOD）活性和 HMGB1 和 NF-κB mRNA 的表达。
咪达唑仑单独或与舒芬太尼联合使用可改善一般指标，延长镇静镇痛持续时间，减少血清 TNF-α和 IL-1β的分泌，不良反应少。同时，HMGB1 和 NF-κB 的表达减少，胰腺血清标志物和 ROS 的产生减少，SOD 活性增加。与模型组相比，差异具有统计学意义（p<0.05），联合组的变化更为显著（p<0.01）。
咪达唑仑联合舒芬太尼可抑制 HMGB1 和 NF-κB 的表达，抑制炎症反应，从而提高镇静镇痛效果，保护胰腺组织，减轻急性胰腺炎损伤。
