Rapid response

  • To help manage intraoperative hemodynamics and pain1
    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 vasopressors.1

Flexible assessment

  • Provides quick emergence for neurological assessment1,3
    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
  • Helps facilitate monitoring of SSEPs and MEPs3,5

Added characteristics of ULTIVA

  • Effective analgesia with less suppressive effects on MEPs than fentanyl, alfentanil, sufentanil, propofol, and thiopental1,5
  • Rapid response to dose adjustment for rapid transition to a wake-up test1,2
    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 after discontinuation with no accumulation regardless of infusion duration1
  • Well-established hemodynamic profile1

Remifentanil is commonly referred to as Remi by anesthesia providers.

Spinal fusion case study

spinal fusion case study

45-year-old female

5'7'', 74 kg (163 lb)

BMI 25.6 kg/m2


  • Hypertension 

History of intraoperative awareness

History of severe postoperative nausea and vomiting (PONV) with morphine

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.



Goal: predictable control

Characteristics of ULTIVA in spinal fusion include:

See also:

  1. ULTIVA [package insert]. Rockford, IL: Mylan Institutional LLC; 2016.
  2. Imani F, Jafarian A, Hassani V, Khan ZH. Propofol-alfentanil vs propofol-remifentanil for posterior spinal fusion including wake-up test. Br J Anaesth. 2006;96(5):583-586.
  3. Samra SK, Dy EA, Welch KB, Lovely LK, Graziano GP. Remifentanil- and fentanyl-based anesthesia for intraoperative monitoring of somatosensory evoked potentials. Anesth Analg. 2001;92(6):1510-1515.
  4. Grottke O, Dietrich PJ, Wiegels S, Wappler F. Intraoperative wake-up test and postoperative emergence in patients undergoing spinal surgery: a comparison of intravenous and inhaled anesthetic techniques using short-acting anesthetics. Anesth Analg. 2004;99(5):1521-1527.
  5. Scheufler KM, Zentner J. Total intravenous anesthesia for intraoperative monitoring of the motor pathways: an integral view combining clinical and experimental data. J Neurosurg. 2002;96(3):571-579.
  6. Guy J, Hindman BJ, Baker KZ, et al. Comparison of remifentanil and fentanyl in patients undergoing craniotomy for supratentorial space-occupying lesions. Anesthesiology. 1997;86(3):514-524.