Well-established hemodynamic profile1,4,5
Helps facilitate early extubation in laparoscopic gastric banding2† and gastric bypass surgery3‡
Added characteristics of ULTIVA
- No accumulation regardless of infusion duration5
- Rapid onset, offset, and recovery for predictable control of responsiveness5
- No difference in pharmacokinetics between nonobese and obese§ patients when normalized to ideal body weight (IBW). Remi should be used with caution in obese patients5,6
Gastric bypass case study
5'9'', 133 kg (292 lb)
BMI 43 kg/m2
- Type 2 diabetes
Medications: metformin; amlodipine/HCTZ
This case study is for illustrative and educational purposes only. The dosing regimen is specific to this case study and other regimens may vary depending on patient and procedure. Any use of this product is subject to the judgment of the practitioner in each case. Please consult the full Prescribing Information in the use of this product.
ULTIVA should be used with caution in obese patients. Clearance of remifentanil generally correlates with total body weight and may vary in morbidly obese patients due to variation in physiology and pharmacodynamics.
- De Baerdemaeker LEC, Jacobs S, Pattyn P, Mortier EP, Struys MMRF. Influence of intraoperative opioid on postoperative pain and pulmonary function after laparoscopic gastric banding: remifentanil TCI vs sufentanil TCI in morbid obesity. Br J Anaesth. 2007;99(3):404-411.
- Bidgoli J, Delesalle S, De Hert SG, Reiles E, Van der Linden PJ. A randomised trial comparing sufentanil versus remifentanil for laparoscopic gastroplasty in the morbidly obese patient. Eur J Anaesthesiol. 2011;28(2):120-124.
- Gaszynski TM, Strzelczyk JM, Gaszynski WP. Post-anesthesia recovery after infusion of propofol with remifentanil or alfentanil or fentanyl in morbidly obese patients. Obes Surg. 2004;14(4):498-503; discussion 504.
- Twersky RS, Jamerson B, Warner DS, Fleisher LA, Hogue S. Hemodynamics and emergence profile of remifentanil versus fentanyl prospectively compared in a large population of surgical patients. J Clin Anesth. 2001;13(6):407-416. Sponsored by Glaxo Wellcome Inc.
- ULTIVA [package Insert]. Rockford, IL: Mylan Institutional LLC; 2016.
- Egan TD, Huizinga B, Gupta SK, et al. Remifentanil pharmacokinetics in obese versus lean patients. Anesthesiology. 1998;89(3):562-573.