Ninety-six patients undergoing arthroscopic rotator cuff repair were randomized to receive placebo (n=32), intravenous TXA (1 g in 200 mL saline; n=32), or TXA (1 g) plus DEX (5 mg) in saline (n=32) within 2 hours postoperatively. The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 hours post-surgery. Secondary outcomes included visual analog scale (VAS) pain scores every four hours up to 24 hours, postoperative blood test results, and American Shoulder and Elbow Surgeons (ASES) score at 3 months. Overall, the results revealed that the combination of TXA and DEX led to significantly lower VAS scores between 5 and 16 hours post-surgery, but did not improve the QoR-15 score at 24 hours compared to other groups. These findings suggest that while TXA+DEX may offer short-term pain relief, it does not significantly enhance early recovery quality after ARCR.