IRCT20200923048817N2 IRCT 2025-06-07 Jeeroft University of Medical Sciences Investigating the effect of Paramedin and Medline methods in headache Investigating the effect of Paramedin and Midline methods on headache after dural puncture following spinal anesthesia in patients undergoing orthopedic surgery in Hospital 2024-08-22 anticipated 160 Complete https://irct.ir/trial/77007 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: 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, Blinding description: Participants are unaware of their allocation to the two groups. N/A Orthopedic surgery. Intervention 1: Intervention group:The midline method (group M) involves passing the needle through the supraspinous, interspinous, and flavum ligaments. Intervention 2: Control group: In the paramedian method (group P), the puncture of the supraspinous and interspinous ligaments is avoided and only the ligament flavum and dura are punctured (punctured). Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is Still undecided - no release schedule yet