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I'd say awareness of it, especially considering AFAIK local anesthesia (as in, fully awake during) doesn't stop the nerves from firing, just from the signals getting to the brain, and I'd say that's blocking the pain.^
Also there's an interesting point in there: (this is not a rebuttal, just an addition)
The reason doctors nowadays use anesthesia, (besides it being squick-y not to) is because it was discovered that, (though they may not consciously remember it) it can manifest in PTSD and other trauma related disorders later in life.^
In addition, it was found that there is a heightened level of stress hormones during surgery on infants, which were absent in surgery done with anesthesia.^ (These stress hormones also increased the risk in post-operational complications, due to the hormones acting to break down carbohydrates and other fats in the infant's bodies)
I've had a lot of different injuries. On heavy morphine and pethadine, you definitely feel pain just as bad but you don't care and just kind of forget about it. It's like it dulls the nervous system in a way that it's not blocking signals, it's blocking how your system reacts to them. It's hard to explain, but it's a pretty surreal experience. You should be stressing, but you're not. You're very aware of the severity of the injury, but you're totally calm about it and it slips your mind, like pain is the lowest concern.
I'm usually thinking like, "I wonder how the fix will go? What if I need to pee? I hope recovery isn't months... Oh, yeah, and my limb is on fire with a bone sticking out, but they're on it. I hope there's no snorers in my ward and the food's good. It'd be nice if they operate this evening because this sucks. I hope I can self-medicate morphine for sleep tonight. That really helped last time. I feel fucking great and am dribbling. Oh, yeah, and my limb is on fire with a bone sticking out. Meh..."
Thank you for sharing your experience!
"carbohydrates and other fats"? Did I not pay attention about carbohydrates in school?