Abstract: the effect of early goal-directed sedation (EGDS) on intracranial pressure and cerebral oxygen metabolism after serious cerebral hemorrhage (SCH), and to provide a new idea for the follow-up treatment of SCH.  
Methods A total of 105 patients with SCH who were admitted to People′s Hospital of Xiangxi Tujia and Miao Autonomous Prefecture were included, and randomly divided into the observation group (n=53) and the control group (n=52). The control group was given routine sedation, and the observation group was given EGDS. The indexes related to cerebral oxygen metabolism before sedation (T1), at 24 h after sedation (T2), at 48 h after sedation (T3), at 72 h after sedation (T4) were compared between the two groups. The heart rate (HR), mean arterial pressure (MAP), cerebral perfusion pressure (CPP) and intracranial pressure (ICP) at each time point were compared between the two groups. 
Results Arterial blood lactate (Lac) of the two groups showed a decreasing trend over time, while cerebral extraction rate of oxygen (CERO2) and cerebral arteriovenous blood oxygen content difference (a-vDO2) showed a fluctuating trend, first decreasing, then increasing, and then decreasing. Juglar venous oxygen saturation (SjvO2) and cerebral arterial oxygen content (CaO2) showed an increasing trend, and the observation group showed more significant changes than the control group. There was a significant difference in the interaction between groups, time points and time points between groups (P＜0.05). Over time, the HR of the observation group showed a fluctuating trend, first decreasing, then increasing, and then decreasing. The HR of the control group showed a decreasing trend, while the MAP of the two groups showed a fluctuating trend. The changes in HR and MAP of the observation group were smoother than those of the control group. There were significant differences in interaction between groups and time points with respect to HR and MAP between the two groups (P＜0.05). There was a significant difference in interaction between groups and time points with respect to HR (P＜0.05), while there was no significant difference in interaction between groups and time points with respect to MAP (P＞0.05). The ICP of the two groups showed an increasing trend over time, while CPP showed a fluctuating trend. There was a significant difference in interaction between the two groups (P＜0.05), while there was no significant difference in the interaction between time points, or between groups and time points (P＞0.05). 
Conclusion The EGDS regimen can more effectively improve the cerebral oxygen metabolism, ICP, and CPP of SCH patients, and can also more accurately maintain the patient′s hemodynamics in a shallow sedation state. 

Key words: cerebral hemorrhage, early goal-directed sedation, intracranial pressure