Neurosciences study human behavior from cold and impersonal data, relatively easy to analyze quantitatively. However, there is one aspect of psychology that cannot be measured directly: the subjective states of consciousness . Perhaps that is why scientists have difficulty in constructing a definition of what consciousness is, what its nature is and on what exactly it is based.

Hence the discoveries being made about the functioning of the brain make the distinction between two states of subjectivity (“conscious” and “unconscious”) blur. Currently there are indications that there might be a third state of consciousness which has been baptized as dysanaesthesia (dysanaesthesia).

Partial consciousness in the operating room

The discovery of this possible third state of consciousness is related to the usual practice of anesthesiologists: putting people to sleep.

The experiment involved asking people who were apparently unconscious from the effect of general anesthesia to move the fingers of a hand that had been isolated from the rest of the body by a tourniquet while being operated on. Interestingly, almost two quarters of the anaesthetised persons obeyed the order as requested , despite the fact that according to the electronic monitoring systems they had to be completely asleep. On the other hand, the doses of anaesthesia given were the normal ones, those that would have been given in any normal operation.

None of the people who participated in the experiment moved their hand for anything other than to follow the orders they were given or seemed to respond in any way to the surgery they were undergoing. Furthermore, once awake, only two of them vaguely remembered moving their hand , and none of them remembered anything about the surgery or claimed to have felt pain.

The third state of consciousness seems to be based on something like selective attention .

Dysanesthesia, or how to expand the repertoire of mental states

The fact that some patients are able to move a part of their body in response to commands could be taken as a sign of consciousness in the operating room, something that can be solved by increasing the dose of anesthesia. However, some anesthesiologists like Dr. Jaideep Pandit believe that these patients are in a third state of consciousness that is not comparable to the one you experience when reading these lines or to the one that occurs when sleeping without dreams.

This could be so because during this “dysanaesthesia” there is some automatic process that is in charge of discerning what are orders directed towards the sleeper from what are not , and therefore makes it possible to react only in some cases and not in others (although these others have to do with metal instruments cutting skin and flesh).

A third state of consciousness is also an uncomfortable idea

This third state of consciousness would therefore only be partial. However, this experiment also exposes the technology currently used to monitor the consciousness of the operating room patient. Apparently, the markers being monitored so far have limited predictive power, and that means that during the operation with general anesthesia many things could be happening in the patient’s consciousness that are not recorded by the machines and remain in the privacy of one’s own subjectivity, even though no memories are kept afterwards.

In the end, this experiment is a reminder that it is difficult to talk about consciousness when you don’t know what it is. Is it possible to define something that is entirely subjective? What if there are types of consciousness that cannot be distinguished by machines? It is possible that dysanaesthesia is a third state of consciousness, but it can also be at the top of a long list of mental states that have yet to be discovered.

Bibliographic references:

  • Pandit, J. J. (2013). Isolated forearm – or isolated brain? Interpreting responses during anaesthesia – or ‘dysanaesthesia’. Anaesthesia, 68(10), pp. 995 – 1000.
  • Russell I. F. (2013). The ability of bispectral index to detect intra-operative wakefulness during isoflurane/air anaesthesia, compared with the isolated forearm technique. Anaesthesia, 68(10): 1010 – 1020.