Venous Tourniquet vs. Arterial Tourniquet for Seizure Monitoring in ECT

This prospective, open-label clinical trial aims to compare a novel "Venous Tourniquet with Regional Low-Dose Sugammadex" method against the gold standard "Arterial Tourniquet" (Isolated Forearm Technique - IFT) for monitoring motor seizure activity during Electroconvulsive Therapy (ECT). Using a within-subject (intra-individual) design, each of the 40 enrolled patients will receive an arterial tourniquet on one arm and a venous tourniquet on the other arm simultaneously. The study will evaluate clinical efficacy in observing motor seizures, comparing the duration and visibility between the two limbs of the same patient, as well as assessing overall patient comfort and hemodynamics.

Inclusion Criteria: * Patients scheduled for elective Electroconvulsive Therapy (ECT). * ASA (American Society of Anesthesiologists) physical status I to III. Exclusion Criteria: * Known neuromuscular diseases (e.g., Myasthenia Gravis). * Known allergy or hypersensitivity to sugammadex, rocuronium, ketamine, dexmedetomidine, or propofol. * Presence of venous insufficiency, lymphedema, or active infection in the upper extremities. * Severe cardiovascular instability.