i routinely give cse for labor, no matter how early in labor, bup 0.5 ml 0,75% in dextrose in spinal (for sacral block for 2nd stage) ,remove spinal needle, then 2-3 ml lido 1.5%  thru epidural needle(kicks in faster and expand epidural space), then pass cetheter , then 3 ml lido 1.55 with epi (as test dose and enough for fast pain relief) ,then when test dose is neg   and 7min after spinal passed (for  sacral block for 2nd stage to settle in) , 10 ml bup 0.0625% fent 2 mcg per cc,and continue pump same concentration 12 ml per hour----they feel contraction, no pain, can deliver without shutting off the pump

i use cse for labor pain, but in spinal i put bupivacain 0.5 ml 0.75% hyperbaric in dextrose and after placing the catheter let them sit for 7 minutes to achieve solid sacral block, sacral block lasts thru whole labor, it s maintained by epidural pump solution(0.0625% 12 ml per hour) leaking thru dural puncture----possible to achieve painless labor---all episotomies,repairs, lacerations   even inserting folley end exam painless
any thoughts ?

i have very good results  doing cs with cse leaving catheter for 3 days (or longer , whatever pts stay) giving duramorph 2 mg epidural   bid   , superior pain relief --pt can get out of bed in 6 hours, can cough ,laugh, move bowels without pain-----pain control unachievable with pca or pills....nurses love me --pts do not complain , nurses do not have to work   
any thought ?