Anesthesiologists discover a third state of consciousness

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

Hence, the discoveries that are being made about the functioning of the brain cause the distinction between two states of subjectivity ("conscious" and "unconscious") to falter. There are now indications that there could be a third state of consciousness which has been baptized as dysanaesthesia (dysanesthesia).

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 consisted of asking people apparently unconscious due to 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 during surgery. Curiously,

almost two quarters of the anesthetized people obeyed the order as requested, despite the fact that according to the electronic monitoring systems they must have been completely asleep. On the other hand, the doses of anesthesia administered 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 continue the orders they were given nor did they seem to respond in any way to the surgery they were undergoing subjected. Also, once you wake up, only two of them vaguely remembered having moved their hand, and none remembered anything about the surgery or claimed to have felt pain.

The third state of consciousness seems to be based on something similar to the 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 taken as a sign of awareness 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 you fall asleep without having dreams.

This could be so because during this "dysaesthesia" there are some automatic process that is responsible for 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 that are monitored so far have limited predictive power, and this means that during the operation under general anesthesia they could be occurring many things in the patient's consciousness that are not registered by the machines and that remain in the privacy of one's own subjectivity, despite the fact that they are not saved afterwards memories.

In the end, this experiment is still a reminder that it is difficult to talk about consciousness when you don't really know what it is. Can you define something that is entirely subjective? What if there are types of consciousness that cannot be distinguished by machines? Dysanesthesia may be a third state of consciousness, but it may also top 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 anesthesia – or ‘dysanaesthesia’. Anesthesia, 68(10), pp. 995 - 1000.
• Russell I. F. (2013). The ability of bispectral index to detect intra-operative wakefulness during isoflurane/air anesthesia, compared with the isolated forearm technique. Anesthesia, 68(10): 1010-1020.