Though i havent done a run but i found a little trick where you can skip atleast one madussa fight which can come in handy for a all quest any% run, im not sure if you can do the skip on the first madussa but you can skip the madussa after you complete the puzzle where you need to stack blocks on top of spikes to get up amd press 3 buttons then instead of going into the center to get to the next pizzle but if you jump to the outer wall on your right hand if you were facing the center but dont go to center but jump around tye outer wall and you could make it to the arrow puzzle room and then you complete the puzzle then the madussa fight for that puzzle should apear and then you should have two madussas to fight but you only need to beat the one then the other one should stop attacking and wander off then you need to continue the run and grab the essence and then go finish the rest of the run.