Why ULTIVA

Rapid response

  • Allows for rapid adjustment of depth of analgesia3
    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 effect3

Rapid recovery

  • Helps facilitate rapid recovery regardless of infusion duration3
    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 care3

Added characteristics of ULTIVA

  • Well-established hemodynamic profile3
    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 vasopressors3
  • No accumulation regardless of infusion duration3
  • Can be used in patients with renal or hepatic impairment3
*

Remifentanil is commonly referred to as Remi by anesthesia providers.

TAVR case study

83-year-old female

5'2'', 64.9 kg (143 lb)

BMI 26 kg/m2

Comorbidities

  • CAD
  • Hypertension
  • Hypercholesterolemia

Recently diagnosed with severe aortic stenosis

Experiences shortness of breath when walking up stairs

Had CABG surgery 3 years ago

Medications: statin, HCTZ, ACE inhibitor

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 elderly patients. The starting doses of ULTIVA should be decreased by 50% in elderly patients (>65 years) and cautiously titrated to effect.

Goal: predictable control

Remi analgesia and TAVR

See also:

  1. Kasel AM, Shivaraju A, Schneider S, et al. Standardized methodology for transfemoral transcatheter aortic valve replacement with the Edwards Sapien XT valve under fluoroscopy guidance. J Invasive Cardiol. 2014;26(9):451-461.
  2. Bergmann L, Kahlert P, Eggebrecht H, Frey U, Peters J, Kottenberg E. Transfemoral aortic valve implantation under sedation and monitored anaesthetic care: a feasibility study. Anaesthesia. 2011;66(11):977-982.
  3. ULTIVA [package insert]. Rockford, IL: Mylan Institutional LLC; 2016.