MASSACHUSETTS GENERAL HOSPITAL
Department of Pharmacy
Department of Nursing
Critical Care

Generic Name : Remifentanil

Trade Name : Ultiva

Action : Opiate analgesic

Indications : Short term analgesia and sedation (<24 hours in ICU)

Restrictions : OR, SICU

Administration Guidelines :

Usual Dosage Range and Route:

LOADING DOSE: 0.5-1 mcg/kg IV over 30-60 seconds
MAINTENANCE DOSE: 0.01-0.2mcg/kg/min IV titrated to patients response

Standard Concentration:

MICROINFUSION: 1000mcg/20mL (50mcg/mL), 2500mcg/50mL (50mcg/mL)

Special Considerations:

• Patient must be ventilated except when induction doses for intubation are being given. Remifentanil must be administered in the presence of a physician trained in airway management
• Drug tolerance may result in need for frequent evaluation of patient response
• Rapid injection will result in increased incidence of side effects up to and including respiratory arrest and significant hypotension.

Precautions and Side Effects:

• Skeletal Muscle/Chest wall rigidity
• Respiratory depression/bronchospasm
• Bradycardia/Tachycardia
• Hyper/Hypotension
• CNS Depression
• Paralytic Ileus
• Pruritus
• Hallucinations