This quality improvement project sought to identify current usage of multimodalanalgesics in cervical spinal fusion procedures utilizing remifentanil infusions. Guided by provider judgment, the choice of specific pain medication combinations can impact patients’ self-reported pain scores in the postoperative recovery room (PACU). While many options are available, commonly used intraoperative medications with analgesic properties include fentanyl, hydromorphone, methadone, ketamine, dexmedetomidine, lidocaine infusions, and magnesium infusions. The literature review supported the use of multimodal analgesia to combat opioid- induced hyperalgesia (OIH) associated with remifentanil. After conducting a retrospective chart review focused on cervical spinal fusion surgeries for 50 patients at a level one academic medical center, postoperative pain scores and pain medication administration were examined for patients who received intraoperative remifentanil infusion in combination with other analgesics. Linear regression identified no significant associations between the number of intraoperative multimodals and the number of doses of pain medications in PACU (b = 0.27, t = 1.00, p = 0.322) or the average pain scores in PACU (b = 0.31, t = 1.28, p = 0.207). Pearson’s r correlations found that none of the individual multimodals were associated with pain medication administration or pain scores in PACU. Although there was a lack of statistically significant findings, it was found that nurse anesthetists were employing a multimodal approach to analgesia and, furthermore, tailoring the anesthetic to each patient’s needs. More study of specific uses of different multimodal analgesics in combination with remifentanil could be beneficial to clinical practices. More research and projects need to be conducted to see if the patient outcome data and the literature agree – that multimodal analgesia can combat OIH associated with remifentanil.