Distinguishing Agency and Subjectivity in Anesthesia: A Review of Neural Mechanisms and Conceptual Frameworks

Anesthesia is an essential practice in modern medicine, however, it has complex and varied effects on consciousness. Variations in conscious states, such as awareness after anesthesia, highlight the distinction between observable responsiveness (agency) and unobservable subjective experience (subjectivity). This review examines and integrates empirical work across scales, from large-scale network dynamics to fine-grained neuronal mechanisms underlying anesthetic-induced unconsciousness. We synthesize findings from existing frameworks, including the Entropic Brain Hypothesis and Dendritic Integration Theory, which explain changes in brain connectivity, dynamics, and neuronal integration under anesthesia. However, neither framework fully addresses how agency and subjectivity may become dissociated. To bridge this gap, we review Irruption Theory (IT) as an emerging conceptual and methodological approach that may offer a novel lens for interpreting measurable changes in neural signals, encouraging further empirical research to distinguish the neural signatures of agency and subjectivity.