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Q: medical ( Answered 5 out of 5 stars,   1 Comment )
Subject: medical
Category: Health > Medicine
Asked by: groendog-ga
List Price: $5.00
Posted: 14 Sep 2003 18:02 PDT
Expires: 14 Oct 2003 18:02 PDT
Question ID: 255862
My friend had a needle biopsy of the liver done without benefit of
anesthesia. Is this SOP or was she at the hands of idiots?
Subject: Re: medical
Answered By: pinkfreud-ga on 14 Sep 2003 19:13 PDT
Rated:5 out of 5 stars
I would not go so far as to say that your friend was in the hands of
idiots, but a local anesthetic is generally used for this procedure:

"Liver biopsy is considered minor surgery and so it is done at the
hospital. For the biopsy, you will lie on a hospital bed on your back
with your right hand above your head. After marking the outline of
your liver and injecting a local anesthetic to numb the area, the
physician will make a small incision in your right side near your rib
cage, then insert the biopsy needle and retrieve a sample of liver

National Digestive Diseases Information Clearinghouse

"The most common way a liver sample is obtained is by inserting a
needle into the liver for a fraction of a second. This can be done in
the hospital with a local anesthetic, and the patient may be sent home
within 3-6 hours if there are no complications."

Twin States Network 

"A liver biopsy is a form of minor surgery that is usually done in the
hospital. An intravenous line, or IV, is started in one of the veins.
The person is then given a sedative and pain medicine. The healthcare
provider will inject local anesthesia to numb the person's right side
near the ribs. For a needle biopsy of the liver, a thin needle is then
inserted. A small piece of liver tissue is drawn out through the
needle. The provider may use an ultrasound to guide the needle
insertion. Pressure is applied to the puncture site to prevent
bleeding, and the site is bandaged."

Discovery Health

"The liver will be palpated and the biopsy site will be selected and
marked, usually at the eight or ninth intercostal space between the
rib cage. A lidocaine anesthetic will be injected into the selected
site to numb the area. A small knife will be used to cut down in
between the ribs to make a hole to insert the biopsy needle."

Battling Hepatitis C

"Liver biopsies have been done for many years.  Prior to about 1950,
they were performed rather rarely and usually surgically at the time
of open surgical operations of the abdomen.  The technique of needle
biopsy of the liver has become commonplace during the past 50 years,
and the great majority of biopsies are now done by this method.  In
it, patients are generally given a local anesthetic at the right side.
 Often times, patients now-a-days request and receive a small amount
of conscious sedation just prior to the procedure."

HCV Advocate  

However, it is not unheard of to proceed without anesthesia:

"An aspiration biopsy involves sucking out cells, typically by
insertion of a needle into the affected tissue. This may require a
local anaesthetic or sometimes no anaesthetic at all."

Here's a post from a Yahoo group in which a patient expresses the wish
that she had received anesthesia for her liver biopsy:

"With regards to the liver biopsy question, my first one was after a
year & a half on meth [methotrexate]... It was interesting to hear
Gordon Elliot talk about his experience of the biopsy. It was the same
as mine, except they gave me NO anesthesia...and I certainly think
that would help a lot!"

Cache of post from Psoriatic Arthritis group on Yahoo

This medical abstract describes a study which indicates that many
patients receive insufficient pain control during this procedure:

"Percutaneous needle liver biopsy is an important procedure for the
diagnosis and evaluation of liver disease and is frequently associated
with pain. In this prospective study, we investigated the prevalence
and characteristics of this pain syndrome... Percutaneous liver biopsy
is a painful procedure in most patients. Mild anxiolytic treatment
plus local anesthetic infiltration seem to produce insufficient
analgesia. A more profound analgesic treatment is required for better
control of this pain."

PubMed Abstract

Another study reached a similar conclusion:

"The intensity of pain experienced during biopsy has not been
specifically studied in the literature probably because pain is
usually short in duration and deemed as minor by most hepatologists...
the results of this pilot study suggest that, although deemed as
minor, pain experienced during percutaneous liver biopsy should be
taken into consideration and that patients should be provided adequate
prophylactic analgesia."

Hepatitis Central

It is unfortunately true that some doctors have a high tolerance for
pain, as long as it is someone else's pain. If your friend was
distressed by the lack of anesthesia during her liver biopsy, she may
want to express this in no uncertain terms to her physician, using the
two medical studies I've mentioned above as documentation that she is
not alone in finding this procedure to be painful.

Google search strategy:

Google Web Search: "needle biopsy" + "liver" + "anesthetic"

Google Web Search: "needle biopsy" liver "without anesthesia"

I hope this helps. Please keep in mind that Google Answers is not a
source of authoritative medical advice; the material I've presented
above is for informational purposes, and should not be taken as a
substitute for the services of a qualified medical professional.

If anything is unclear, or if a link does not function, please request
clarification; I'll gladly offer further assistance before you rate my

Best wishes,
groendog-ga rated this answer:5 out of 5 stars and gave an additional tip of: $5.00
I have long suspected that doctors are not always the best judges of
what their procedures involve, until they have been
victims..uh..patients.. I meant to say patients--themselves. Thank you
for a fast and very informative answer.

Subject: Re: medical
From: pinkfreud-ga on 14 Sep 2003 19:36 PDT
Thank you very much for the five-star rating and the generous tip.


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