Most doctors will not do percutaneous needle liver biopsies under
anesthesia. This is because the liver is directly under the diaphragm and
moves as you breathe. When the needle is inserted through the skin and
body wall, the liver must not be moving or else there is danger of a
laceration. To keep the liver from moving, the patient has to stop
breathing momentarily. Doctors prefer to have you alert and following
directions, but if you are very anxious you may want to ask for a
sedative to help you relax.
The injections of the local anesthetic and the actual puncture of the liver
capsule itself can be a little painful for some people, but it only takes
a second and is over very quickly. Other people feel no pain at all, and
don’t even realize it’s over with until the doctor tells them they’re
finished.
Occasionally there will be a small to moderate amount of pain afterwards. If
you find that you are uncomfortable, your doctor will generally prescribe
a light painkiller immediately after the biopsy. The pain may be well
away from the biopsy site, possibly in the pit of your stomach or
typically in the right shoulder. Some doctors are really hesitant to
give pain killers to those with hepatitis C. Please make sure you have
some just in case, by clearing up this matter before hand. After my
second biopsy, I was in so much pain I was crying for hours, and I had to
argue with the nurse to get some medication. The pain subsided after 24
hours, but both Joan and I were very worried (squeeky).
The liver itself has no pain-sensing nerve fibers, but a small amount of blood in the abdominal cavity or up under the diaphragm can be irritating and painful. Very occasionally, small adhesions (scar tissue) may form at or near the biopsy site, and can cause a chronic pain that persists near the liver area after the biopsy.
