Medetomidine, midazolam, and butorphanol anesthesia with preoxygenation enables magnetic resonance imaging and cerebrospinal fluid examination in rabbits.

MMB anesthesia with continuous oxygen supplementation safely enables MRI and CSF collection in rabbits.

This study evaluated the feasibility of an intramuscular medetomidine, midazolam, and butorphanol (MMB) anesthetic protocol with oxygen supplementation for neurological diagnostic procedures in rabbits. Five adult male rabbits participated in a randomized crossover design comparing oxygen supplementation (OG; 3 L/min via mask) versus room air (AG) during MMB anesthesia (medetomidine 0.15 mg/kg, midazolam 1.0 mg/kg, butorphanol 1.5 mg/kg IM), with atipamezole and flumazenil used for reversal. Arterial blood gases, oxygen saturation (SpO2), and anesthesia scores were monitored. In the air group, SpO2 dropped significantly, with a least median of 86% and PaO2 remaining below 88 mmHg (defined as hypoxemia), requiring 4 of 5 rabbits to receive rescue oxygen. The oxygen group maintained SpO2 at 98–100% throughout. Both groups exhibited elevated PaCO2 after 5 minutes, indicating hypoventilation in both conditions. Immobilization was adequate in both groups, and all rabbits recovered successfully following antagonist administration. In a second experiment, MRI and cerebrospinal fluid (CSF) collection were successfully performed under MMB with continuous oxygen supplementation, demonstrating clinical practicality. The protocol offers a fully reversible, injectable anesthetic option suitable for advanced neurological diagnostics in rabbits without requiring inhalant anesthesia equipment. Clinicians should be aware of the hypoventilation risk and monitor PaCO2 closely. This MMB protocol with preoxygenation represents a practical and safe approach for MRI and CSF examinations in exotic rabbit patients.

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