Inclusion Criteria:  Age: 30-65 years, both sexes ASA physical status class II and III 2-3 levels elective lumbar surgery. Controlled non- insulin dependent diabetic patients (HbA1C ≤ 7% )  Exclusion Criteria:  Cervical and thoracic surgery More than 3 levels surgery. Cognitive impairment. Infection, trauma, neoplasm. Revision surgery. Patients with BMI > 35 kg/m2, renal or cardiac and liver failure. Patients with retinopathy or reduction of visual acuity. Patients with known hypersensitivity or contraindication to medications. Coagulopathy or uncontrolled Diabetes mellitus (DM) . Patients receiving any analgesic medications within 24 h pre-operative or antiplatelet medication within the past 1 week. Patients who had symptoms of nausea and vomiting or received an antiemetic within 24 h of surgery. Random blood glucose more than 250 mg/dl just before shifting the patient from the ward to the operating room.