Objective To study the cerebral protective effect of intravenous propofol anaesthesia on the patients with acute severe brain injury.Methods 70 patients with acute severe brain injury were randomly divided into control group and observation group,each group had 35 cases.The observation group was given intravenously propofol 2mg/kg for anesthesia induction,then maintaining anesthetization by 4mg · kg-1 · h-1.The control group was given midazolam,then discontinuous indrawed isoflurane.Diprivan 1.2mg/kg,fentanyl 4μ g/kg and vecuronium bromide 0.15 mg/kg were also used intravenously for the maintenance of anesthesia.The changes of intracranial pressure (IP)and cerebral oxygen partial pressure(COP) before anesthetization,surgery,3 hours after surgery and the waking time of surgery were recorded.Results After treatment,IP of two groups was decreased and COP was increased sharply; the IP of observation group was (18.98 ± 3.98) mm Hg,which was lower than (21.76 ± 4.01)mm Hg of the control group(t =7.20,P ＜ 0.05),COP was (17.09 ± 3.03) mm Hg,which was higher than (14.67 ± 2.63)mm Hg of the control group (t =7.23,P ＜ 0.05).The wake time of observation group was (15.98 ± 2.01) h,which was shorter than (20.01 ± 1.23) h of the control group (t =7.96,P ＜ 0.05).Conclusion The cerebral protective effect of intravenous propofol anaesthesia is good in patients with acute severe brain injury;it is worth to popularize in clinic.