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The TXA group received a preoperative intravenous infusion of TXA (15 mg\/kg) over 15 minutes with normal saline irrigation, while the EPN group received irrigation with 0.33 mg\/L EPN in normal saline without intravenous TXA. Both patients and surgeons were blinded to the interventions. Visual clarity was assessed by surgeons using a numeric rating scale (0\u201010). Secondary outcomes included operative time, irrigation fluid volume, pump pressure, perioperative hemodynamic parameters, postoperative pain and swelling, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The EPN group showed higher visual clarity scores than the TXA group, with a mean difference of 1.41 (95% confidence interval [CI], 0.55\u20102.28;\n                      <jats:italic>P<\/jats:italic>\n                      = .002) on a 0 to 10 scale. In contrast, the TXA group exhibited a significantly higher proportion of cases requiring increased pump pressure during surgery compared to the EPN group, with an absolute difference of 34.1% and an odds ratio of 4.4 (95% CI, 1.5\u201012.7;\n                      <jats:italic>P<\/jats:italic>\n                      = .002). The average pump pressure was also higher in the TXA group than in the EPN group (mean difference, 3.2 mm Hg, 95% CI, 1.36\u20105.04;\n                      <jats:italic>P<\/jats:italic>\n                      = .001). No serious adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intravenous TXA was marginally less effective than EPN irrigation in bleeding control during arthroscopic rotator cuff repair and showed less improvement in visual clarity, with no severe adverse events observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2025.05.034","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T02:32:09Z","timestamp":1749090729000},"page":"4460-4468","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intravenous Tranexamic Acid Is Marginally Inferior to Epinephrine Irrigation for Visual Clarity During Arthroscopic Rotator Cuff Repair: A Double\u2010Blind, Randomized Controlled Trial"],"prefix":"10.1002","volume":"41","author":[{"given":"Son Quang","family":"Tran","sequence":"first","affiliation":[{"name":"Clinical Sciences Program Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Department of Orthopaedics Faculty of Medicine Can Tho University of Medicine and Pharmacy Can Tho Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thun","family":"Itthipanichpong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Sports Medicine Research Group Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danaithep","family":"Limskul","sequence":"additional","affiliation":[{"name":"Department of 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