Objective To develop a volume management program in the anesthesia intensive care unit (AICU) for adolescents undergoing scoliosis surgery and evaluate its clinical application effects. Methods A total of 48 adolescent scoliosis patients were conve-niently enrolled as the control group from May to October 2024 and received routine AICU volume management measures.Another 47 adolescent scoliosis patients were recruited as the experimental group from May to October 2025 and implemented the specialized AICU volume management program for adolescent scoliosis.The following outcomes were compared between the two groups:in-cidence of postoperative fluid overload, fluid balance during AICU stay, lactate level at AICU discharge, heart rate (HR) and mean arterial pressure (MAP) at admission (T0), 6 h (T1), 12 h (T2), 24 h (T3), 36 h (T4) and 48 h (T5) after surgery, duration of mechanical ventilation, length of AICU stay, total postoperative hospital stay, and incidence of postoperative complications. Results No dropouts occurred in the two groups.The experimental group had significantly lower incidence of fluid overload, AICU fluid balance volume, duration of mechanical ventilation, length of AICU stay, postoperative hospital stay, and postoperative complication rate compared with the control group (all P＜0.05).Repeated-measures analysis of variance (ANOVA) revealed a significant interaction effect between time and group on HR (P＜0.05).For MAP, a significant time effect was observed (P＜0.05), while no statistically significant group effect or interaction effect was detected (all P＞0.05). Conclusion The implementation of the specialized AICU volume management program for adolescent scoliosis patients can effectively optimize postoperative volume status and promote enhanced recovery after surgery.