Ultimately in anaesthesia, the mind may not recall the experience but the body still feels it. You see this in unparalysed body’s that flinch when they’re cut, or in fully paralysed bodies that signal pain in an observable increase in heart rate and blood pressure. However, most the time, people are also given substantial analgesics to reduce their likelihood of experiencing pain, but the point I’m trying to make is an unconscious person is still able to feel pain of they have not been given adequate pain relief.
Like, you get a cut, and the trigger is the "damage" that then triggers pain and the heart rate rising. It's not the pain itself that triggers the heart rate but the damage. Maybe? Idk
I had proper surgery a few days later which involved being knocked out for two hours or so. That's a whole different situation. You start counting down and you are gone within a few seconds.
You can give someone a small dose of Midazolam, they might report feeling a little dizzy, or say they feel like they’ve had a few drinks, but they will have absolutely no recall of the experience, despite interacting like a slightly tipsy “conscious person” - I like how they call it “conscious sedation” - most people end up believing they were unconscious.
I've read some horror stories online about people having postoperative nightmares about what they experienced while on the operating table while under versed, so I was really afraid to take it when I went under general anesthesia myself.. but I've had it a bunch of times now, and never experienced anything like that myself.
My postoperative amnesia has been complete, and I'm happy for that.
On the other hand, I still worry about what I might have experienced that I don't remember.
There's also an interesting thing where the anesthesia you get is likely to be very different for the same procedure if you get the procedure at a hospital versus an outpatient clinic. Because anesthesia at a hospital is typically a department with influence, and turf wars happen.
It is worth asking why this argument does not also apply events like the die-rolling case, and it is because the state of the world immediately after the event is strongly constrained by its state immediately before.
The argument quoted above tacitly assumes there are no such prior constraints in the case of consciousness, but this does not seem to be supportable. If it were so, it would seem that our minds would be constantly taking a random walk through a vast number of possibilities, and it seems inconceivable that there could be consciousness in that case.
Anesthesia for surgery is more complicated and involves a cocktail of different drugs, administered in a particular sequence, tending to include paralytic drugs as well as special inhaled drugs that we don't even really know how they work (eg sevoflurane). It amounts to a much deeper state of anesthesia than the conscious sedation used in things like GI endoscopy and wisdom tooth extraction.
IANAA (I Am Not An Anesthesiologist) but I like to read about stuff like this and ask my doctors about it whenever it comes up for me.
I consciously remember saying "Wow, this is working way faster than I thought it would" right before the dental assistant told me to go to sleep if I felt like it.
I have some memories of the surgery happening, like my head being jerked around when they pulled teeth out, but it was painless. Immediately after the surgery after I "woke up" I felt like I could remember quite a bit of the procedure but that feeling faded after some time and it all felt like a dream.
>At doses near the unconsciousness threshold, some anesthetics block working memory (20). Thus, patients may fail to respond because they immediately forget what to do. At much lower doses, anesthetics cause profound amnesia. Studies with the isolated forearm technique, in which a tourniquet is applied to the arm before paralysis is induced (to allow the hand to move while the rest of the body is paralyzed), show that patients under general anesthesia can sometimes carry on a conversation using hand signals, but post-operatively deny ever being awake (21). Thus, retrospective oblivion is no proof of unconsciousness.
Edit: there are some sections of this article that could prompt some interesting discussion from the crowd here. For example, from a subsection "Consciousness and integrated information":
>The evidence from anesthesia and sleep states (Fig. 2–3) converges to suggest that loss of consciousness is associated with a breakdown of cortical connectivity and thus of integration, or with a collapse of the repertoire of cortical activity patterns and thus of information (Fig. 2). Why should this be the case? A recent theory suggests a principled reason: information and integration may be the very essence of consciousness (52). Classically, information is the reduction of uncertainty among alternatives: when a coin falls on one of its two sides, it provides 1 bit of information, whereas a die falling on one of six faces provides ~2.6 bits. But then having any conscious experience, even one of pure darkness, must be extraordinarily informative, since we could have had countless other experiences instead (think of all the frames of every possible movie). Having any experience is like throwing a die with a trillion faces and identifying which number came up (Fig. 2). On the other hand, every experience is an integrated whole that cannot be subdivided into independent components. For example, with an intact brain you cannot experience the left half of the visual field independently of the right half, or visual shapes independently of their color. In other words, the die of experience is a single one throwing multiple dice and combining the numbers will not do.