Rapid response

  • Allows for rapid titration to help control intraoperative pain and hemodynamics1,3*,4
    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
    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

Rapid recovery

  • Facilitates rapid recovery with no accumulation regardless of infusion duration1
    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 profile1
  • No accumulation regardless of infusion duration1
  • Can be used in patients with renal or hepatic impairment1

In patients undergoing upper and lower eyelid blepharoplasty or otoplasty under local anesthesia.3

Study evaluated 40 patients undergoing septorhinoplasty randomized to receive desflurane-Remi or total intravenous anesthesia including Remi. Hemodynamic parameters were not significantly different between groups.4

Remifentanil is commonly referred to as Remi by anesthesia providers.

Rhytidectomy (facelift) case study

63-year-old female

63-year-old female

5'8", 65.8 kg (145 lb)

BMI 22.0 kg/m2


  • Hypertension
  • Postmenopausal
  • Smoker

Previous hysterectomy for cervical adenocarcinoma

Medication: lisinopril

Uses herbal supplements

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.

Plastic surgery TIVA plan

Plastic surgery balanced plan

Goal: predictable control

Characteristics of ULTIVA in ambulatory plastic surgery include:

Plastic surgery timelines

See also:

  1. ULTIVA [package insert]. Rockford, IL: Mylan Institutional LLC; 2016.
  2. Rama-Maceiras P, Ferreira TA, Molíns N, Sanduende Y, Bautista AP, Rey T. Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiol Scand. 2005;49(3):305-311.
  3. Ferraro GA, Corcione A, Nicoletti G, Rossano F, Perrotta A, D’Andrea F. Blepharoplasty and otoplasty: comparative sedation with remifentanil, propofol, and midazolam. Aesthetic Plast Surg. 2005;29(3):181-183.
  4. Gokce BM, Ozkose Z, Tuncer B, Pampal K, Arslan D. Hemodynamic effects, recovery profiles, and costs of remifentanil-based anesthesia with propofol or desflurane for septorhinoplasty. Saudi Med J. 2007;28(3):358-363.
  5. Tuncel U, Turan A, Bayraktar MA, Erkorkmaz U, Kostakoglu N. Efficacy of dexamethasone with controlled hypotension on intraoperative bleeding, postoperative oedema and ecchymosis in rhinoplasty. J Craniomaxillofac Surg. 2013;41(2):124-128.
  6. Koşucu M , Omür S, Beşir A, Uraloğlu M, Topbaş M, Livaoğlu M. Effects of perioperative remifentanil with controlled hypotension on intraoperative bleeding and postoperative edema and ecchymosis in open rhinoplasty. J Craniofac Surg. 2014;25(2):471-475.
  7. 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.
  8. 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.
  9. 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.