Reappraisal of Lytic Cocktail/Demerol, Phenergan, and Thorazine (DPT) for the Sedation of Children

This Policy Statement was retired January 2005. The DPT lytic cocktail remains a widely used sedative and analgesic for pediatric patients. Neither the combination itself nor its dosage is based on sound pharmacologic data. There is a high rate of therapeutic failure as well as a high rate of serious adverse reactions, including respiratory depression and death, associated with its use. Even when it is effective, DPT appears to lack many of the desirable characteristics of a sedative for children. Specifically, the dose cannot be titrated easily and individually, the onset of action is significantly delayed (20 to 30 minutes), the duration of sedation is protracted (5 to 20 hours), the duration of analgesia is much shorter (1 to 3 hours), and no anxiolytic or amnestic properties exist.