In this review, the relationship between the classical physics and the theory of the pharmacokinetics was analyzed. All solutes in the tissue react, according to the second law of thermodynamics, from high energy level to lower energy level. Each solute has its thermal-energy which is converted to kinetic-energy and induces free diffusion in the environment. For example, movement of oxygen molecule in the tissue can be explained by the diffusion equation and the result fits well to the arrangement of vascular structurein the living body. This is because oil-soluble substances like oxygen or inhalation anesthetics pass cell membrane freely. On the other hand, water-soluble substances like potassium or sodium ion which is distributed unevenly in the tissue, need extra energy to maintain the same condition. This unevenness creates osmotic pressure between inside and outside of the cell. The term permeability or filtration coefficient has been developed from the theory of diffusion kinetics.
In this article, two clinical cases of cardiac arrest which induced by accidental infusion of potassium solution were presented together with simulation analysis. The obtained data showed good agreement with the experimental data. The difference between the bolus injection and the continuous infusion of the potassium was also clarified with this method.

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Continuous epidural morphine has been used to provide long-lasting postoperative analgesia after upper-gastrointestinal operations. However, the incidence of pruritus, nausea, vomiting and respiratory depresssion detract from the use of this method. Combination of epidural morphine (μ-agonist) and butorphanol (μ-antagonist and κ-agonist) was administered to increase analgesic efficacy and decrease μ-receptor mediated side effects. Patients received 2 mg of morphine (group 1), 2mg of butorphanol (group 2), each 2mg of morphine and butorphanol (group 3) with continuous administration of each drugs 0.1mg/hr. Patients were monitored for 24h after the end of surgery. No significant changes were seen with the groups in heart rate, mean arterial pressure. Group 3 provided most effective analgesia. Among μ-receptor mediated side effects, pruritus and respiratory depression were eliminated in Group 3 though nausea, vomiting and CNS depression still remained.

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A 44 year-old man with tracheal tumor was scheduled for tracheoplasty. He had severe dyspnea due to tracheal stenosis. Anesthesia was induced with fentanyl 100μg iv and isoflurane 1% in oxygen. Respiration and gas exchange were maintained by assist ventilation with a mask and by partial cardiopulmonary bypass. Because of the difficulty in ventilating the patient after an unexpected rupture of the bilateral pleurae and difficulty in increasing the cardiopulmonaly bypass flow, hypercarbia developed until an endtracheal tube was placed in the trachea distal to the tumor. To obtain enough cardiopulmonary bypass flow for gas exchange, the number and size of cannulas should be carefully selected.

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We experienced 2 patients in whom transient left bundle branch block (LBBB) developed perioperatively.
In the first case, a 40-year-old woman, it was difficult to distinguish the wide QRS wave pattern from ventricular tachycardia, because of the presence of atrial fibrillation. The wide QRS pattern was converted into the previous pattern by the administration of 10mg of diltiazem.
In the second case, an 81-year-old woman, LBBB pattern was found before the induction of anesthesia. However, it disappeared immediately after 100% oxygen was given via a face mask. But it appeared intermittently during anesthesia, and became permanent from the 4th postoperative day.
Neither patient showed any signs of myocardial damage, and both recovered uneventfully, and were discharged.

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For 9 cases with difficult intubation, we tried a new method to intubate a tracheal tube using with the Laryngeal mask(LM). The LM could be successfully inserted in all patients. In our method, the 5.5mm endotracheal tube without cuff was passed through the size 2 LM, and 6.5mm endotracheal tube with cuff was passed through the size 3 and 4 LM. After LM insertion, endotracheal tube was introduced to LM with aid of fiberscope. Then the fiberscope was manipulated to identify the epiglottis and vocal cord. After that fiberscope was advanced into the trcheal and the endotracheal tube placed over it. There were no changes in S_pO₂ and in HR during endotracheal intubation by this method. The tracheal intubation through the LM was performed easily, because the fiberscope had already aligned for good visualization of the vocal cord thorugh the LM.We conclude that this technique in very useful for difficult intubation.

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