Investigating the effect of Paramedin and Midline methods on headache after dural puncture following spinal anesthesia in patients undergoing orthopedic surgery in Hospital

Determining the effect of two Paramedin and Medline methods on headache after dura rupture in spinal anesthesia in patients undergoing orthopedic surgery in Hospital

A controlled, single-blind, randomized, parallel-group clinical trial was conducted on 160 patients after attrition.

This study is an interventional study. Our target population includes orthopedic surgery patients under spinal anesthesia in Imam Khomeini (RA) Jiroft Hospital in 1402. The random assignment is that we consider two groups A and B, after that we put even numbers in group A and odd numbers in group B, and finally one group is named M and the other group is named We consider P. Before the intervention in the two groups (M and P), the initial information of the patients such as age, gender, height and weight, before the start of the anesthesia procedure from the file and items such as the number of dural punctures performed from the patients' anesthesia chart will be entered into the checklist. After that, the intervention and collection of questionnaires in the two groups will be

The inclusion criteria included the age group of 18 to 40 years and people with headaches, people with a ruptured dura mater following spinal anesthesia, and patients undergoing orthopedic surgery. The exclusion criteria included patients with other acute and chronic diseases.

In the two groups P and M, the intervention is as follows: The midline method (group M) involves passing the needle through the supraspinous, interspinous, and flavum ligaments, while in the paramedian method (group P), puncturing the supraspinous and interspinous ligaments is avoided and only the flavum and dura are punctured.

duration of headache; intensity of headache; The nature of the headache

The random sequence is such that for all people undergoing orthopedic surgery, the checklist is completed on different days of the week (both even and odd days) until the desired sample size is reached. Then, each checklist was assigned a code from 1 to 160. The random assignment is such that we consider two groups called A and B, then we randomly place the checklists with even codes in one group and the checklists with odd codes in the other group, and finally, considering that people are randomly placed in two groups, we name one group as M and the other group as P.

Participants are unaware of their allocation to the two groups