Many people don’t regard “you’ll be in pain and then forget” as the same as “no pain.”
And the idea that HR and BP are perfect indicators of pain is ridiculous. Anesthetics reduce the responsiveness of both; cardiac parameters don’t respond perfectly, and you don’t need perfect anesthesia to impair them.
In my hospital, at least, we don’t take for granted that we achieve perfect coverage. It’s normal to give patients a bolus of amnestic at the tail end of a procedure to cover any gap in pain/distress while we were bringing them back to consciousness.