Comparison of Post-Dural Puncture Headache After Spinal Anesthesia Using Median Versus Paramedian Approach

Exclusion Criteria

• •Any contraindication to spinal anesthesia, including infection at puncture site, coagulopathy or therapeutic anticoagulation, thrombocytopenia, severe hypovolemia or shock, raised intracranial pressure due to space occupying lesion, or suspected spinal canal infection.
• •Known hypersensitivity to planned intrathecal local anesthetic or adjuvant drugs.
• •History of chronic daily headache, migraine requiring regular prophylaxis, or headache at baseline on the day of surgery.
• •Prior lumbar spine surgery, significant spinal deformity, or neurological disease affecting lower limb sensation that will interfere with neuraxial assessment.
• •Inability to complete follow-up assessments due to impaired cognition, severe psychiatric illness, or major communication barrier.
• •Emergency procedures.