Our ICU + CVICU have a Sedation/Analgesia protocol that includes Precedex if the physician signs that section of it.
We start at 0.2 mcg/kg/hr, able to titrate to a max of 1.2 mcg/kg/hr.
The level of sedation we aim for is for the pt to be pretty much asleep if no one is in the room, and easily arousable if you stimulate them. They can still communicate wants/needs/pain.
Using Precedex, we don't need to do a sedation vacation. We can check neuro status anytime that we want. Also, Precedex doesn't affect respiratory drive, so they can still be on it when extubated.
I've only used it so far in my hospital's Medical ICU, not in our CVICU (CABG pts).
So far I feel like it's a wonder drug with my experiences with it.
When I work next week I'll try to remember to email myself a copy of my hospital's Sedation/Analgesia protocol to put on here.