Starting with fentanyl for that reason doesn't make much sense.

I use remi all the time.  Clinically used doses are 'potent' because it is a short acting drug.  Thus, you can get some stiffness, but no different than with any other of the narcotics listed below.

I always mix with propofol and have no problems anyway - 1 mg remi in 50 cc propofol.

Besides, that is what rocuronium or other relaxant is for.

But generally - no relaxant needed with 10cc of the above mixture. (but maybe a little ephedrine).

Regarding end of infusion.  You can add some other narcotic or not.

I find that meperidine is great.  Knocks out shivering which is more common when recovering from remi infusion.

What is MAC?   All anesthesia care is MAC.

But for billing, all anesthesia care is GA. Period.

You get paid for your anesthesia time with the patient.  Don't use a term like 'MAC' which makes absolutely no sense and might give someone an excuse not to pay you.