Do I have to be awake for my liver biopsy? I know they want you to hold your breath when the doctor sticks in the needle, but is that really necessary? I’m afraid i’ll move or have a panic attack just as he sticks in the needle.

Awake & comfortable. You need not be fully awake but general anesthesia for a quick procedure such as a liver biopsy is not necessary. Moderate sedation is often used in this situation to relieve anxiety and pain. Also, the performing physician should make sure to use adequate local anesthesia. The combination of sedation and good local anesthesia should make this a very safe and comfortable procedure.
General . General anesthesia is not needed for a liver biopsy. Your doctor will most likely give you an intravenous medication to relieve your anxiety, so a panic attack is not very likely. Please take a look at the health guide i posted on this site regarding conscious sedation, which is the safer and more appropriate alternative to general anesthesia for procedures like liver biopsy.
CBT. Seek a cognitive-behavioral therapist who specializes in phobias. One method they use is systematic desensitization which slowly and incrementally brings the person closer and closer to the thing they are afraid of in slow, graduated steps that help make the anxiety more tolerable.
Ask doc. Ask your doctor for an injection to calm you during the procedure, as that may be possible. Everyone is nervous when getting a needle stuck in their liver, so docs are used to dealing with this and will not allow you to move during the procedure.