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 ?