Abstract:[Abstract] Objective Cerebral infarction is often complicated with severe bulbar paralysis, and the time of traditional endotracheal intubation is late. The purpose of this study is to explore the effect of early endotracheal intubation combined with analgesia and sedation in the treatment of cerebral infarction complicated with severe bulbar paralysis. Methods From May 2020 to may 2021, 70 patients with cerebral infarction complicated with severe bulbar paralysis were treated in our department. They were divided into early intubation group (35 cases) and traditional intubation group (35 cases). After intubation, propofol and remifentanil were given for analgesia and sedation. The indexes of the two groups were compared: the arterial blood gas analysis indexes before and after intubation; Severity of illness before endotracheal intubation (NIHSS score, GCS score, mRS score, Water swallow test score, AIS-APS score); The incidence of systemic complications (pulmonary infection, gastrointestinal bleeding, acute heart failure, acute renal failure); Clinical outcome and prognosis: time from onset to intubation (h), length of stay in ICU, number of patients unable to extubate for a long time, time from intubation to extubation of extubable patients (days), prognosis evaluation at 3 months (NIHSS score, GCS score, mRS score, Water swallow test score, AIS-APS score)); Results The arterial blood gas analysis indexes were improved in both groups after intubation (P <0.05); Before endotracheal intubation, the condition of traditional intubation group was more serious (P <0.05); Early intubation group can significantly reduce the incidence of lung infection, gastrointestinal bleeding, acute heart failure (P <0.05), renal failure has a decreasing trend, but there is no statistical difference (P >0.05); In the early intubation group, the time from onset to intubation was shorter (P <0.05); The length of stay in ICU was shorter (P <0.05); There was no significant difference between the two groups in the number of patients who could not extubate for a long time (P > 0.05); The time from intubation to extubation in extubable patients was shorter in the early intubation group (P <0.05); The prognosis of early intubation group was better at 3 months (NIHSS score, GCS score, mRS score, Water swallow test score, AIS-APS score, P < 0.05). Conclusion Early tracheal intubation combined with analgesia and sedation can reduce the severity of the disease before intubation, reduce the incidence of systemic complications, promote the recovery of the disease, and improve the long-term prognosis.