Rapid response

  • Allows for rapid titration to the desired depth of analgesia as required by varying levels of intraoperative stress1
    Continuous infusions of Remi* should be administered only by an infusion device. The injection site should be close to the venous cannula and all IV tubing should be cleared at the time of discontinuation of infusion. Interruption of an infusion of Remi will result in rapid offset of effect1

Rapid recovery

  • Facilitates rapid recovery from outpatient and ambulatory surgery1
    Due to the rapid offset of action of Remi, no residual analgesic activity will be present within 5 to 10 minutes after discontinuation. For patients undergoing surgical procedures where postoperative pain is generally anticipated, alternative analgesics should be administered prior to discontinuation of Remi. The choice of analgesic should be appropriate for the patient's surgical procedure and the level of follow-up care1

Added characteristics of ULTIVA

  • Well-established hemodynamic profile in inpatient and outpatient procedures1,2
    In premedicated patients undergoing anesthesia, 1-minute infusions of
    <2 mcg/kg of Remi cause dose-dependent hypotension and bradycardia. When appropriate, bradycardia and hypotension can be reversed by reduction of the rate of infusion of Remi or the dose of concurrent anesthetics, or by the administration of fluids or vasopressors1
  • No accumulation regardless of infusion duration1
  • Can be used in patients with renal or hepatic impairment1

Remifentanil is commonly referred to as Remi by anesthesia providers.

Arthroscopic knee surgery case study

40-year-old male, orthopedic case study

40-year-old male

6'3", 88.5 kg (195 lb)

BMI 24.4 kg/m2


  • Hypertension

History of delayed arousal following prior anesthetics

Medication: lisinopril

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.

Orthopedic TIVA plan

Orthopedic balanced plan

*Remifentanil is commonly referred to as Remi by anesthesia providers.

Goal: predictable control

Characteristics of ULTIVA in ambulatory orthopedic surgery include:

Orthopedic timelines

See also:

  1. ULTIVA [package insert]. Rockford, IL: Mylan Institutional LLC; 2016.
  2. 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.
  3. Cartwright, DP, Kvalsvik O, Cassuto J, et al. A randomized, blind comparison of remifentanil and alfentanil during anesthesia for outpatient surgery. Anesth Analg. 1997;85(5):1014-1019.
  4. Philip BK, Scuderi PE, Chung F, et al. Remifentanil compared with alfentanil for ambulatory surgery using total intravenous anesthesia: the Remifentanil/Alfentanil Outpatient TIVA Group. Anesth Analg. 1997;84(3):515-521. Supported in part by Glaxo Wellcome Inc.
  5. Mathews DM, Gaba V, Zaku B, Neuman GG. Can remifentanil replace nitrous oxide during anesthesia for ambulatory orthopedic surgery with desflurane and fentanyl? Anesth Analg. 2008;106(1):101-108.