Comparing Spinal, Epidural, and Dural Puncture Epidural Anesthesia for Cesarean Delivery: Hemodynamics and Block Quality

The goal of this clinical trial is to compare three regional anesthesia techniques (spinal, epidural, and dural puncture epidural anesthesia) in healthy pregnant women undergoing planned (elective) cesarean delivery. The main questions it aims to answer are: Which technique causes less low blood pressure (maternal hypotension) and requires less vasopressor medication during surgery? Which technique provides faster and more effective surgical anesthesia? Spinal anesthesia works quickly but often causes a sudden drop in blood pressure, while epidural anesthesia is more stable but slower and sometimes incomplete. Dural puncture epidural is a newer technique that may combine the speed of spinal anesthesia with the stability of epidural anesthesia. A total of 120 participants will be randomly assigned in equal numbers to one of the three groups. Researchers will compare the groups for blood pressure and heart rate changes, number of hypotension episodes, vasopressor use, time to reach adequate block (T6 level), block quality, need for additional pain medication, and side effects such as nausea, vomiting, and headache. Newborn well-being will be assessed with Apgar scores and umbilical cord blood gas analysis. Maternal and surgeon satisfaction will also be recorded.