This clinical trial examines whether intravenous preoperative administration of tranexamic acid (TXA) before arthroscopic rotator cuff repair (ARCR) can improve arthroscopic visualization during the procedure.

Inclusion Criteria:

• Age 18-100
• Male and Female
• Patient able to read and understand consent form
• Non-traumatic, simple small or medium sized rotator cuff tear as defined by pre-operative MRI
• Booked to operating room for elective rotator cuff repair
• Beach chair positioning

Exclusion Criteria:

• Patient refusal to participate
• Massive rotator cuff tear
• Acute traumatic rotator cuff tear
• Known coagulopathy
• Patients with a history or risk of thromboembolism
• Known hypersensitivity to tranexamic acid
• Patient unable to be off anti-coagulant medication for long enough to counter effects
• Patient has a clinic systolic blood pressure > 150mmHg
• Lateral positioning
• Requirement or insistence by patient or anesthesiologist on regional block
• Patients who have smoked nicotine products within the last year
• The presence of other inflammatory conditions (calcific tendonitis, rheumatoid arthritis, etc.)
• The presence of active thromboembolic disease, such as deep vein thrombosis, pulmonary embolism, and cerebral thrombosis
• Patient has a seizure disorder
• Patients on medications identified as having drug-drug interactions (hormonal contraceptive, hydrochlorothiazide, desmopressin, sulbactam-ampicilllin, carbazochrome, ranitidine, or nitroglycerine
• Patient is pregnant
• Patients with history of subarachnoid hemorrhage
• Patients with renal insufficiency
• Patients with acquired disturbances of color vision

Surgeons are blinded to group allocation and all treatment is administered by the anesthesia care provider. Patients will not be informed of their allocation.