A 29 year old nulliparous woman at 39 weeks gestation presents to the labor and delivery suite at 2:00 AM with onset of regular uterine contractions. You are called to evaluate her because she is experiencing considerable pain with each contraction. Her exam on admission shows that her cervix is two centimeters dilated, and 30% effaced. You ascertain that three weeks ago she switched obstetricians, and she has not had an anesthesia consultation. Her surgical history is significant for insertion of Harrington rods at age 13 for adolescent idiopathic scoliosis. She has not experienced problems related to her spine surgery except for some mid-back pain, worsened during pregnancy and now involving her lower back, not radiating to her lower extremities. She has no allergies and takes no medications other than prenatal vitamins. Her height is 5’7” and her current weight is 230 lbs. She has a Mallampati class III airway. She has a midline scar on her back extending from approximately T2 to L4. She also has a 12 cm scar over her left hip. Her nurse sent a blood sample for a complete blood count and type and screen. The patient is adamant that she wants pain relief, as her contraction pain has become unbearable. She did not bring a copy of her operative report nor did she bring any imaging studies of her spine. She continues to insist that her first choice for pain relief is an epidural, and she is begging you to administer it as soon as possible.

What is you plan?